Individual
DR. THEODORE L SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 E MARSHALL AVE, SUITE 410, LONGVIEW, TX 75601-5659
(903) 236-4115
(903) 753-9748
Mailing address
PO BOX 731218, DALLAS, TX 75373-1218
(903) 236-4115
(903) 753-9748
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
E6175
TX
Other
Enumeration date
10/20/2005
Last updated
06/19/2013
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