Organization
INTEGRATED SLEEP CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL GUAJARDO (PRESIDENT)
(210) 824-9919
Entity
Organization
Contact information
Practice address
910 SAN PEDRO AVE, SUITE 2, SAN ANTONIO, TX 78212-4642
(210) 824-9919
(210) 824-9917
Mailing address
PO BOX 12549, SAN ANTONIO, TX 78212-0549
(210) 824-9919
(210) 824-9917
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7317641
AETNA
TX
01
—
PL7119
BLUE CROSS BLUE SHIELD
TX
Enumeration date
03/06/2007
Last updated
04/16/2013
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