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Individual

DR. JAMES WALLACE SLAUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
120 E HARRIS AVE, EMERGENCY ROOM, SAN ANGELO, TX 76903-5904
(325) 653-6741
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
J3615
TX
207R00000X
Internal Medicine Physician
J3615
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127626306
TX
05
127626309
TX
01
8K7851
BCBS
TX
Enumeration date
09/12/2005
Last updated
05/19/2011
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