Provider Demographics
NPI:1629089305
Name:JAMES L SLATER D.O. P.A.
Entity Type:Organization
Organization Name:JAMES L SLATER D.O. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:II
Authorized Official - Credentials:DO
Authorized Official - Phone:214-526-2121
Mailing Address - Street 1:7447 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7509
Mailing Address - Country:US
Mailing Address - Phone:214-526-2121
Mailing Address - Fax:214-526-2142
Practice Address - Street 1:7447 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 180
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-7509
Practice Address - Country:US
Practice Address - Phone:214-526-2121
Practice Address - Fax:214-526-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6184208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty