Healthcare Provider Details

I. General information

NPI: 1639130313
Provider Name (Legal Business Name): ELENA GENOVA SLAVCHEVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2802 WEBBERVILLE RD
AUSTIN TX
78702-2947
US

IV. Provider business mailing address

1111 E CESAR CHAVEZ ST
AUSTIN TX
78702-4209
US

V. Phone/Fax

Practice location:
  • Phone: 512-978-8130
  • Fax:
Mailing address:
  • Phone: 512-978-8130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberK1063
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: