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Individual

MARTIN VAN SLOAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1150 N 18TH ST, STE 206, ABILENE, TX 79601
(325) 695-1890
(325) 695-1665
Mailing address
1150 N 18TH ST, STE 206, ABILENE, TX 79601-2931
(325) 695-1890
(325) 695-1665

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0872
TX
213EP1101X
Primary Podiatric Medicine Podiatrist
PD872
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
PD872
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004395004
AETNA
TX
01
00FJ64
BLUE CROSS BLUE SHIELD
TX
05
0187064-01
TX
01
0288250001
DMERC NSC
TX
01
0288250002
DMERC NSC ROCKWALL
TX
01
124202100
FIRSTCARE
TX
01
480004770
RAILROAD MEDICARE
TX
Enumeration date
07/15/2005
Last updated
07/19/2018
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