Organization Name: | ROBERT E. SLOCUM, D.O.,P.A. |
NPI Number: | 1578891198 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT E SLOCUM (PRESIDENT) |
Mailing Address: | 4925 Greenville Ave Suite 1158 Dallas |
State: | TX US |
Postal Code: | 752064026 |
Phone Number: | 2146911224 |
Fax Number: | 9722711650 |
NPI Enumeration Date: | 11/19/2009 |
NPI Last Update Date: | 09/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C8852 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |