| Sleep Well Southeast Texas LLC | |
|
3033 Marina Bay Dr Ste 230 League City TX 77573-3982 | |
| (281) 222-9924 | |
| Not Available |
| Full Name | Sleep Well Southeast Texas LLC |
|---|---|
| Speciality | Dentist |
| Location | 3033 Marina Bay Dr Ste 230, League City, Texas |
| Authorized Official Name and Position | Derek Tieken (OWNER) |
| Authorized Official Contact | 2812229924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sleep Well Southeast Texas LLC 3033 Marina Bay Dr Ste 230 League City TX 77573-3982 Ph: (281) 222-9924 | Sleep Well Southeast Texas LLC 3033 Marina Bay Dr Ste 230 League City TX 77573-3982 Ph: (281) 222-9924 |
| NPI Number | 1356911440 |
|---|---|
| Provider Enumeration Date | 06/30/2021 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Medicare PECOS PAC ID | 3870962467 |
|---|---|
| Medicare Enrollment ID | O20221202000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356911440 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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