Provider Demographics
NPI:1346691417
Name:MOBILE SLEEP AND NEURODIAGNOSTICS
Entity type:Organization
Organization Name:MOBILE SLEEP AND NEURODIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:512-947-2044
Mailing Address - Street 1:3405 SAVAGE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5904
Mailing Address - Country:US
Mailing Address - Phone:512-947-2044
Mailing Address - Fax:
Practice Address - Street 1:3405 SAVAGE SPRINGS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5904
Practice Address - Country:US
Practice Address - Phone:512-947-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Single Specialty