Theodore L Slade, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

E6175 Issued in TX

Practice address

701 E Marshall Ave
Suite 410
Longview, TX 75601-5659

Phone

(903) 236-4115

Fax

(903) 753-9748

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1447249552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731218",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731218",
            "telephone_number": "903-236-4115",
            "fax_number": "903-753-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E MARSHALL AVE",
            "address_2": "SUITE 410",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015659",
            "telephone_number": "903-236-4115",
            "fax_number": "903-753-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADE",
        "first_name": "THEODORE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "E6175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cori Elena Skarda, MD
• Shayne Taylor Skarda, M.D.
• Emily Margaret Skoog, M.D.
• Hunter Skoog, MD
• Sara Slabisak, MD
• Sleep Well Longview PLLC
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• Rodney Bayron Slone, M.D.
• Wanda Ellen Smart, L.P.C.
• Smiles of Tomorrow

• Neurological Surgery Physician in Longview, TX
• Providers in Longview, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.