Provider Demographics
NPI:1770833956
Name:SLOVACEK, ELEAH MARIE (DPT)
Entity type:Individual
Prefix:DR
First Name:ELEAH
Middle Name:MARIE
Last Name:SLOVACEK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 HAZELTON ST
Mailing Address - Street 2:APT. B
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-3187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:TX
Practice Address - Zip Code:78648-3213
Practice Address - Country:US
Practice Address - Phone:830-875-8500
Practice Address - Fax:830-875-5029
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1218417225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist