Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R1650 | TX |
N | 111NI0900X | Internist | R1650 | TX |
NPI | 1003236548 |
---|---|
Provider Name | Dr. Jonathan Edward Slovik |
First Address | San Antonio, TX 78229-4402 |
Second Address | San Antonio, TX 78229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2014 |
Last Update Date | 11/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
377702102 | (05) | TX |
377702103 | CSHCN (01) | TX |