Charles Thornton Slack, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

J0267 Issued in TX

Practice address

1105 Central Expy North
Suite 370
Allen, TX 75013

Phone

(214) 495-6464

Fax

(214) 509-0273

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive SurgeryAlso: General Surgery

Education

University of Texas Southwestern Medical School at Dallas, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1720038151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 PECAN HOLLOW TRL",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750709061",
            "telephone_number": "972-562-7253",
            "fax_number": "214-509-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 CENTRAL EXPY NORTH",
            "address_2": "SUITE 370",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "75013",
            "telephone_number": "214-495-6464",
            "fax_number": "214-509-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "CHARLES",
        "middle_name": "THORNTON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "J0267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Skye Skidmore
• Sarah Skillett
• Skin Specialists, PA
• SKM Dentistry of Allen
• Skyline Anesthesia PLLC
• Madison Slagle
• Kyla Michelle Slaughter, M.S., CCC-SLP
• Sleep Medicine Associates of Texas
• Alexis Sleiter
• Bridgett Garlette Small

• Plastic Surgery Physician in Allen, TX
• Providers in Allen, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.