Provider Demographics
NPI:1598952012
Name:SLATE, DENNIS (PSYD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:SLATE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 SILVER LURE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-8140
Mailing Address - Country:US
Mailing Address - Phone:281-796-1485
Mailing Address - Fax:
Practice Address - Street 1:5330 GRIGGS RD
Practice Address - Street 2:SUITE B-108
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-3700
Practice Address - Country:US
Practice Address - Phone:713-533-0022
Practice Address - Fax:713-533-9915
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33518103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical