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General NPI Number Information
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NPI Number | 1619484615
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Entity Type | Organization
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Legal Business Name | MARTIN V SLOAN DPM
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 6800 HERITAGE PKWY STE 104
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City | ROCKWALL
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State | TX
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Zip | 75087-8746
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Country | US
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Telephone | 972-412-9400
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Fax | 972-412-9416
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Provider Business Mailing Address
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Address Line | 1150 N 18TH ST STE 206
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City | ABILENE
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State | TX
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Zip | 79601-2931
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Country | US
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Telephone | 325-695-1890
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARTIN VAN SLOAN
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Credential | DPM
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Telephone | 325-695-1890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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