Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 12056 | TX |
Y | 111NI0900X | Internist | 12056 | TX |
N | 111NN0400X | Neurology | 12056 | TX |
N | 111NN1001X | Nutrition | 12056 | TX |
NPI | 1356696462 |
---|---|
Provider Name | Dr. Phil Sledz |
First Address | Austin, TX 78731-6400 |
Second Address | Austin, TX 78731-6400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 16/07/2012 |