Provider Demographics
NPI:1265881882
Name:EXECUTIVE CPAP AND SLEEP SERVICES OF HOUSTON, LLC
Entity type:Organization
Organization Name:EXECUTIVE CPAP AND SLEEP SERVICES OF HOUSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMPAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT, RST, RRT
Authorized Official - Phone:281-229-0094
Mailing Address - Street 1:24030 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPLENDORA
Mailing Address - State:TX
Mailing Address - Zip Code:77372-5912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1525 LAKEVILLE DR STE 202
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-229-0094
Practice Address - Fax:346-223-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-04
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BX2000X
TX1001775332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies