MEDICARE: MS. SYDNEY E SLYE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	21146	TX

General Provider Information

NPI Number	:	1821001413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SYDNEY E SLYE LCSW

Provider Business Mailing Address
First Line	:	13310 PARTRIDGE HL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-6526
Country	:	US
Telephone Number	:	210-494-6340
Fax Number	:	210-494-6340

Provider Business Practice Location Address
First Line	:	12915 JONES MALTSBERGER RD
Second Line	:	424
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4282
Country	:	US
Telephone Number	:	210-494-6340
Fax Number	:	210-494-6043

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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