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NPI Code Detail

MEDICARE: CAROL L SLETTE O.D.

MEDICARE: CAROL L SLETTE O.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
1152W00000XOptometrist5062TGTX
2152W00000XOptometrist5584TGTX
3152W00000XOptometrist6062TGTX
4152W00000XOptometrist6785TGTX
5152W00000XOptometrist4344TGTX

General Provider Information

NPI Number : 1215130869
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROL L SLETTE O.D.
Provider Business Mailing Address
First Line : 1616 CLEAR LAKE CITY BLVD STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8069
Country : US
Telephone Number : 281-286-4343
Fax Number : 281-286-4344
Provider Business Practice Location Address
First Line : 1616 CLEAR LAKE CITY BLVD STE 103
Second Line :
City : HOUSTON
State : TX
Zip : 77062-8069
Country : US
Telephone Number : 281-286-4343
Fax Number : 281-286-4344
Authorized Official
Title or Position : OWNER
Name : CAROL L. SLETTE
Credential : O.D.
Telephone Number : 281-286-4343
Provider Enumeration Date : 06/08/2007
Last Update Date : 11/05/2012

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