MEDICARE: ROBERT E. SLOCUM, D.O.,P.A.

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	208D00000X	General Practice Physician	C8852	TX

General Provider Information

NPI Number	:	1578891198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT E. SLOCUM, D.O.,P.A.

Provider Business Mailing Address
First Line	:	3314 RANCH DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75041-4449
Country	:	US
Telephone Number	:	214-691-1224
Fax Number	:	972-271-1650

Provider Business Practice Location Address
First Line	:	4925 GREENVILLE AVE
Second Line	:	SUITE 1158
City	:	DALLAS
State	:	TX
Zip	:	75206-4026
Country	:	US
Telephone Number	:	214-691-1224
Fax Number	:	972-271-1650

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT E SLOCUM
Credential	:	D.O.
Telephone Number	:	214-691-1224

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	09/26/2011

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