MEDICARE: DR. J MACK SLAUGHTER JR. M.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	390200000X	Student in an Organized Health Care Education/Training Program
2	207P00000X	Emergency Medicine Physician	Q7479	TX

General Provider Information

NPI Number	:	1831533827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J MACK SLAUGHTER JR. M.D.

Provider Business Mailing Address
First Line	:	5658 FULL MOON CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2533
Country	:	US
Telephone Number	:	817-219-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5658 FULL MOON CT
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-2533
Country	:	US
Telephone Number	:	817-219-8400
Fax Number	:

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

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	01/05/2017

Similar Medicare Providers

1427405083 — ABLECARE GROUP HOME LLC
Practice Location Address:

2533 MILL SPRINGS PASS
FORT WORTH, TX
76123-2615

Practice Phone: 817-443-8775
Practice Fax:

1720437031 — POINT OF GRACE GROUP HOME
Practice Location Address:

2533 MILL SPRINGS PASS
FORT WORTH, TX
76123-2615

Practice Phone: 972-835-3642
Practice Fax:

1740731017 — POINT OF GRACE HOME HEALTH, LLC
Practice Location Address:

2533 MILL SPRINGS PASS
FORT WORTH, TX
76123-2615

Practice Phone: 817-443-8775
Practice Fax: 817-886-7303

1457801391 — POINT OF GRACE HOME HEALTH
Practice Location Address:

2533 MILL SPRING PASS
FORT, TX
76123

Practice Phone: 817-443-8775
Practice Fax:

1740719632 — DISHONDA HOPKINS LCSW
Practice Location Address:

2533 GEORGETOWN LN
FORT WALTON BEACH, FL
32547-6818

Practice Phone: 850-830-5262
Practice Fax:

1861354060 — SARAH MARIE HESTER LCSW/LISW
Practice Location Address:

70 CONCORD AVE
FORT THOMAS, KY
41075-2533

Practice Phone: 859-391-1877
Practice Fax:

Directions to “ DR. J MACK SLAUGHTER JR. M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.