Sharlet Slough Do | |
6115 New Copeland Rd Ste 240 Tyler TX 75703 | |
(903) 617-6239 | |
(903) 617-6249 |
Full Name | Sharlet Slough Do |
---|---|
Speciality | Internal Medicine |
Location | 6115 New Copeland Rd Ste 240, Tyler, Texas |
Authorized Official Name and Position | Sharlet Slough (OWNER) |
Authorized Official Contact | 9036176239 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sharlet Slough Do Po Box 8819 Tyler TX 75711-8819 Ph: (903) 617-6239 | Sharlet Slough Do 6115 New Copeland Rd Ste 240 Tyler TX 75703 Ph: (903) 617-6239 |
NPI Number | 1699867366 |
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Provider Enumeration Date | 09/29/2006 |
Last Update Date | 07/05/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699867366 | NPI | - | NPPES |
DG2129 | Other | TX | RAILROAD MEDICARE PIN |
0055PW | Other | TX | BCBS |
185213901 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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