Healthcare Provider Details

I. General information

NPI: 1992806764
Provider Name (Legal Business Name): EMILY KAY SLOAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 11/21/2022
Certification Date: 11/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BUCKNER BLVD #139
DALLAS TX
75217-1704
US

IV. Provider business mailing address

1401 S BUCKNER BLVD #139
DALLAS TX
75217-1704
US

V. Phone/Fax

Practice location:
  • Phone: 469-488-4400
  • Fax: 469-488-4401
Mailing address:
  • Phone: 469-488-4400
  • Fax: 469-488-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM4550
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: