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General NPI Number Information
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NPI Number | 1164538427
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Entity Type | Individual
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Provider Name | JAN SLOVACEK F.N.P.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3128 S HIGHWAY 35
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City | ALVIN
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State | TX
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Zip | 77511-4737
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Country | US
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Telephone | 281-886-8964
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Fax |
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Provider Business Mailing Address
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Address Line | 2600 FM 1764 RD STE 190
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City | LA MARQUE
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State | TX
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Zip | 77568-2826
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Country | US
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Telephone | 281-886-8964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 629732
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License Number State | TX
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