Provider Demographics
NPI:1467440180
Name:SLATER, PATRICK W (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:W
Last Name:SLATER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12319 N MOPAC EXPY
Mailing Address - Street 2:BLDG. C, SUTIE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2403
Mailing Address - Country:US
Mailing Address - Phone:512-454-0341
Mailing Address - Fax:512-454-9915
Practice Address - Street 1:12319 N MOPAC EXPY
Practice Address - Street 2:BLDG. C, SUTIE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2403
Practice Address - Country:US
Practice Address - Phone:512-454-0341
Practice Address - Fax:512-454-9915
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2012-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5006207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047540201Medicaid
TXF40533Medicare UPIN
TX047540201Medicaid