Provider Demographics
NPI:1841200326
Name:SLEZAK, SYLVIA (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:SLEZAK
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 1:3200 LONG PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2718
Mailing Address - Country:US
Mailing Address - Phone:972-355-3771
Mailing Address - Fax:972-539-0066
Practice Address - Street 1:3200 LONG PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2718
Practice Address - Country:US
Practice Address - Phone:972-355-3771
Practice Address - Fax:972-539-0066
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N66KMedicare ID - Type Unspecified
TXF76448Medicare UPIN