# SLAROD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922353358
- **Authorized official:** DR. JASON A WILLIAMS MD (OWNER)
- **Authorized official phone:** (214) 462-7887

## Contact information

- **Practice address:** 546 E SANDY LAKE RD, 100, COPPELL, TX 75019-5786
- **Practice address phone:** (214) 462-7887
- **Mailing address:** 1365 FM 740 S, FORNEY, TX 75126-5342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | M0969 | TX | Yes |

## Other

- **Enumeration date:** 07/23/2012
- **Last updated:** 07/23/2012