Provider Demographics
NPI:1316451412
Name:SLEEP WELL LONGVIEW PLLC
Entity type:Organization
Organization Name:SLEEP WELL LONGVIEW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNERSHIP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-663-5895
Mailing Address - Street 1:3121 H G MOSLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-2942
Mailing Address - Country:US
Mailing Address - Phone:903-663-0861
Mailing Address - Fax:
Practice Address - Street 1:3121 H G MOSLEY PKWY
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2942
Practice Address - Country:US
Practice Address - Phone:903-663-0861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-28
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X, 332BC3200X
TX17240332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17240OtherLICENSE NUMBER
TX16065OtherLICENSE NUMBER