Provider Demographics
NPI:1699182618
Name:MEDICAL CENTER SLEEP SOLUTIONS PLLC
Entity type:Organization
Organization Name:MEDICAL CENTER SLEEP SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-703-4115
Mailing Address - Street 1:521 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4109
Mailing Address - Country:US
Mailing Address - Phone:281-332-7565
Mailing Address - Fax:281-332-0617
Practice Address - Street 1:521 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4109
Practice Address - Country:US
Practice Address - Phone:281-332-7565
Practice Address - Fax:281-332-0617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15127122300000X, 1223P0300X, 332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment