Organization Active NPI

Stephen Glenn Slade MD PA

Doing business as Slade & Baker Vision Center

  • Ophthalmology Physician
  • Houston, TX
National Provider Identifier
1053698464
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
F7175 Issued in TX
Legal business name
STEPHEN GLENN SLADE MD PA
Doing business as
Slade & Baker Vision Center
Practice address
3900 Essex LN
Suite 101
Houston, TX 77027-5133
Phone
(713) 626-5544
Fax
(713) 626-7744
NPI assigned
Nov 14, 2011
Last updated
Oct 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Delfina A Villegas
Title
Assistant Manager
Phone
(713) 626-5544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X F7175 TX Primary

Addresses

Primary practice location

3900 Essex LN
Suite 101
Houston, TX 77027-5133

Mailing address

3900 Essex LN
Suite #101
Houston, TX 77027-5133
Phone (713) 626-5544

Other names 1

  • Slade & Baker Vision Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120307000581 TX Part B Supplier - Clinic/Group Practice 3678732864 Receives reassigned benefits from 5 practitioners
Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2043888Slade and Baker Vision Center3900 Essex LN, Ste 101, Houston, TX 77027Certificate of waiverJul 11, 2026

National Provider Directory

National Provider Directory

Locations

3900 Essex Ln
Houston, TX 77027
Phone (713) 442-8700

3900 Essex Ln
Ste 101
Houston, TX 77027
Phone (713) 626-5544

9725 Datapoint Dr
Ste 100
San Antonio, TX 78229
Phone (210) 428-6788

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1053698464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 ESSEX LN",
            "address_2": "SUITE #101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275133",
            "telephone_number": "713-626-5544",
            "fax_number": "713-626-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 ESSEX LN",
            "address_2": "SUITE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275133",
            "telephone_number": "713-626-5544",
            "fax_number": "713-626-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN GLENN SLADE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "VILLEGAS",
        "authorized_official_first_name": "DELFINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "713-626-5544",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F7175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Slade & Baker Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.