Individual
JEREMY D SLATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, 1014, HOUSTON, TX 77030-3000
(832) 325-7080
(713) 512-2239
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
L8510
TX
2084N0600X
Clinical Neurophysiology Physician
Primary
L8510
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164376901
—
TX
01
—
164376902
CSHCN
TX
01
—
8F6715
BCBS
TX
Enumeration date
06/27/2006
Last updated
10/31/2018
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