Provider Demographics
NPI:1306332283
Name:GREAT NIGHT SLEEP COMPANY LLC
Entity type:Organization
Organization Name:GREAT NIGHT SLEEP COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:WILKINSON
Authorized Official - Last Name:OSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-924-1114
Mailing Address - Street 1:1309 AVON TER
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9509
Mailing Address - Country:US
Mailing Address - Phone:214-924-1114
Mailing Address - Fax:214-924-1114
Practice Address - Street 1:1309 AVON TER
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9509
Practice Address - Country:US
Practice Address - Phone:214-924-1114
Practice Address - Fax:214-924-1114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117011223G0001X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherSLEEP MEDICINE