Individual
CHARLES THORNTON SLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1105 CENTRAL EXPY NORTH, SUITE 370, ALLEN, TX 75013
(214) 495-6464
(214) 509-0273
Mailing address
1405 PECAN HOLLOW TRL, MCKINNEY, TX 75070-9061
(972) 562-7253
(214) 509-0273
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
J0267
TX
Other
Enumeration date
05/10/2006
Last updated
04/23/2013
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