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General NPI Number Information
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NPI Number | 1982046348
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Entity Type | Individual
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Provider Name | LAURA L SLADECEK RPH
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Gender | Female
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 2800 W STATE HIGHWAY 22
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City | CORSICANA
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State | TX
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Zip | 75110-2454
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Country | US
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Telephone | 903-872-3784
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Fax |
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Provider Business Mailing Address
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Address Line | 13721 FM 1394
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City | WORTHAM
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State | TX
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Zip | 76693-4542
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Country | US
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Telephone | 254-765-3705
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 35154
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License Number State | TX
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