Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | P6089 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | P6089 | TX |
NPI | 1174815880 |
---|---|
Provider Name | Dr. Paul Douglas Slocum JR. |
First Address | Dallas, TX 75251-2213 |
Second Address | Dallas, TX 75251-2213 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2011 |
Last Update Date | 20/08/2019 |