Individual
DR. J MACK SLAUGHTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5658 FULL MOON CT, FORT WORTH, TX 76132-2533
(817) 219-8400
Mailing address
5658 FULL MOON CT, FORT WORTH, TX 76132-2533
(817) 219-8400
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q7479
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/22/2013
Last updated
01/05/2017
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