Clinic of Pulmonary Sleep and Healthy Aging, P.a.
Organization Active NPI Pulmonary Disease Physician · Pleasanton, TX
NPI 1376043596 · NPPES record last updated Jun 1, 2022
Key facts
- NPI
- 1376043596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- K9525 (TX)
- Legal business name
- CLINIC OF PULMONARY SLEEP AND HEALTHY AGING, P.A.
- Practice address
- 220 W Goodwin St Ste B
Pleasanton, TX 78064-4119 - Phone
- (830) 480-5133
- Fax
- (830) 480-5144
- NPI assigned
- Feb 14, 2018
- Organization subpart
- No
Authorized official
- Name
- Gustavo Ferreira, M.D.
- Title
- President
- Phone
- (830) 480-5133
Practitioners 3
-
Gustavo Adolfo Ferreira, M.D.
-
Diki Ann Reyes, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180328000073 | TX | Part B Supplier - Clinic/Group Practice | 6709148950 |
Receives reassigned benefits from 1 practitioner Practice locations: Pleasanton, TX |
National Provider Directory
Locations
220 W Goodwin St
Ste B
Pleasanton, TX 78064
Phone (830) 480-5133
1342 W Goodwin St
Pleasanton, TX 78064
Phone (830) 480-5133
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician |
207RP1001X | K9525 | TX | Yes |
Addresses
Primary practice location
220 W Goodwin St Ste B
Pleasanton, TX 78064-4119
Mailing address
PO Box 1051
Pleasanton, TX 78064-1041
Phone (830) 480-5133
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00Q89H | Other | TX | BCBS |
Other providers in Pleasanton, TX
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- Lisa Michelle Capps
- Center Pharmacy Inc
- Angela Marie Chapa
- Charlotte Isd
- Community Family Health
- Concentra Primary Care PA
- Ilyssa Condra
- Heather A Conn
- Brandi Christine Conway
All providers in Pleasanton, TX · Pulmonary Disease Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.