Provider Demographics
NPI:1477508448
Name:SLAVCHEVA, EVGENIA GENOVA (MD)
Entity Type:Individual
Prefix:DR
First Name:EVGENIA
Middle Name:GENOVA
Last Name:SLAVCHEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12221 N MOPAC EXPY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-2401
Mailing Address - Country:US
Mailing Address - Phone:512-901-4009
Mailing Address - Fax:512-901-3992
Practice Address - Street 1:12221 N MOPAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-2401
Practice Address - Country:US
Practice Address - Phone:512-901-4009
Practice Address - Fax:512-901-3992
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5510174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192306202Medicaid
TX0798795-01Medicaid
P00232628OtherRR MEDICARE
TX192306202Medicaid
TX0798795-01Medicaid
TX8K4797Medicare PIN