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Organization

RON E. SLATE JR DPM PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RON E. SLATE JR. DPM PLLC (MEDICAL DIRECTOR/OWNER)
(979) 848-0777
Entity
Organization

Contact information

Practice address
2036 E MULBERRY ST, ANGLETON, TX 77515-3923
(979) 848-0777
(979) 849-0757
Mailing address
2036 E MULBERRY ST, ANGLETON, TX 77515-3923
(979) 848-0777
(979) 849-0757

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
332BC3200X
Customized Equipment (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00528W
MEDICARE GROUP PTAN
TX
05
152063702
TX
05
171187104
TX
01
5304710001
MEDICARE DME PTAN
TX
01
8B8071
MEDICARE INDIVIDUAL PTAN
TX
Enumeration date
08/23/2006
Last updated
08/20/2025
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