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General NPI Number Information
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NPI Number | 1831516947
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Entity Type | Organization
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Legal Business Name | WELLNESS DIAGNOSTIC FIRST, INC
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 3501 MIDWAY RD STE 250
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City | PLANO
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State | TX
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Zip | 75093-8116
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Country | US
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Telephone | 817-461-6374
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Fax | 817-461-8550
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Provider Business Mailing Address
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Address Line | PO BOX 495
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City | MIDLOTHIAN
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State | TX
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Zip | 76065-0495
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Country | US
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Telephone | 817-461-6374
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Fax | 817-461-8550
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DAVID SLATER
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Credential | M.D.
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Telephone | 817-461-6374
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | L7564
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L7564
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License Number State | TX
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