Organization Active NPI

Erik Sloman-Moll, P.a.

  • Specialist
  • Laredo, TX
National Provider Identifier
1518149491
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
K6333 Issued in TX
Legal business name
ERIK SLOMAN-MOLL, P.A.
Practice address
10410 Medical Loop Unit 4B
Laredo, TX 78045-6672
Phone
(956) 794-8870
Fax
(956) 795-8384
NPI assigned
Dec 3, 2007
Last updated
Feb 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Erik R Sloman-Moll, M.D., P.A.NPI 1700830221
Title
President/Owner
Phone
(956) 794-8870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K6333 TX Primary

Addresses

Primary practice location

10410 Medical Loop Unit 4B
Laredo, TX 78045-6672

Mailing address

10410 Medical Loop Unit 4B
Laredo, TX 78045-6672
Phone (956) 794-8870

Other identifiers 4

IdentifierTypeStateIssuer
152677402MedicaidTX
193200000XMedicaidTX
237600000XMedicaidTX
102575104MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050106000081 TX Part B Supplier - Clinic/Group Practice 5799733754 Receives reassigned benefits from 1 practitioner
Practice locations: Laredo, TX

National Provider Directory

National Provider Directory

Locations

10410 Medical Loop
Bldg 4B
Laredo, TX 78045
Phone (956) 794-8870

Practitioners & affiliated clinicians

Practitioners 2

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": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1518149491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10410 MEDICAL LOOP UNIT 4B",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456672",
            "telephone_number": "956-794-8870",
            "fax_number": "956-795-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10410 MEDICAL LOOP UNIT 4B",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456672",
            "telephone_number": "956-794-8870",
            "fax_number": "956-795-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIK SLOMAN-MOLL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "SLOMAN-MOLL",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "956-794-8870",
        "authorized_official_credential": "M.D., P.A."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K6333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152677402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193200000X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237600000X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102575104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.