MEDICARE: DR. VICTORIA JENICE SLOAN PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2-3481	TX

General Provider Information

NPI Number	:	1043205198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORIA JENICE SLOAN PH.D

Provider Business Mailing Address
First Line	:	1139 GLORIA CT
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3844
Country	:	US
Telephone Number	:	281-491-2990
Fax Number	:	281-491-4835

Provider Business Practice Location Address
First Line	:	7447 HARWIN DR
Second Line	:	STE 215A
City	:	HOUSTON
State	:	TX
Zip	:	77036-2016
Country	:	US
Telephone Number	:	713-521-2155
Fax Number	:	713-266-2067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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