MEDICARE: DR. SYLVIA SLEZAK 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	207Q00000X	Family Medicine Physician	J6245	TX

General Provider Information

NPI Number	:	1841200326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIA SLEZAK M.D.

Provider Business Mailing Address
First Line	:	3200 LONG PRAIRIE RD
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2718
Country	:	US
Telephone Number	:	972-355-3771
Fax Number	:	972-539-0066

Provider Business Practice Location Address
First Line	:	3200 LONG PRAIRIE RD
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-2718
Country	:	US
Telephone Number	:	972-355-3771
Fax Number	:	972-539-0066

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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