Provider Demographics
NPI:1285234468
Name:SLOW WAVE, INC.
Entity type:Organization
Organization Name:SLOW WAVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:281-787-5589
Mailing Address - Street 1:26100 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SPICEWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:78669-1362
Mailing Address - Country:US
Mailing Address - Phone:210-379-6269
Mailing Address - Fax:
Practice Address - Street 1:617 N US 281
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5141
Practice Address - Country:US
Practice Address - Phone:830-220-5700
Practice Address - Fax:830-220-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX76041759786540000OtherTRICARE EAST
AL901-51505OtherBCBS AL
10078388OtherCDRH FDA CLEARED SLOW WAVE, INC. SLOW WAVE DS8 ANTI-SNORING SLEEP APNEA
FLNG92VOtherFLORIDA BLUE
TX535244OtherBCBS TX
K191320OtherCDRH FDA CLEARED K191320 SLOW WAVE, INC. MEDICAL DEVICE SLOW WAVE DS8