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NPI Code Detail

MEDICARE: MICHAEL M SLAUGHTER FNP

MEDICARE: MICHAEL M SLAUGHTER FNP
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
1363L00000XNurse Practitioner687662TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F0179018OTHERTXDPS

General Provider Information

NPI Number : 1306151022
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL M SLAUGHTER FNP
Provider Business Mailing Address
First Line : 2514 LARCHMONT DR
Second Line :
City : MESQUITE
State : TX
Zip : 75150-5230
Country : US
Telephone Number : 214-558-1104
Fax Number : 972-216-1535
Provider Business Practice Location Address
First Line : 1216 CHURCH ST
Second Line :
City : SULPHUR SPRINGS
State : TX
Zip : 75482-2108
Country : US
Telephone Number : 903-885-2820
Fax Number : 903-885-2989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2010
Last Update Date : 03/07/2023

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