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General NPI Number Information
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NPI Number | 1821697962
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Entity Type | Individual
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Provider Name | MILES SLAY DPT
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Gender | Male
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 19411 MCKAY DR
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City | HUMBLE
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State | TX
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Zip | 77338-5713
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Country | US
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Telephone | 281-446-2680
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Fax |
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Provider Business Mailing Address
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Address Line | 4533 EDFIELD ST
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City | HOUSTON
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State | TX
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Zip | 77051-1909
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Country | US
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Telephone | 678-599-7371
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1338049
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License Number State | TX
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