Individual provider Active NPI

Carrie O Slezak, R.D.

  • Registered Dietitian
  • Southlake, TX
National Provider Identifier
1740502905
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DT88105 Issued in TX
Practice address
321 W Southlake Blvd
Southlake, TX 76092-6188
Phone
(817) 488-4186
NPI assigned
Feb 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X DT88105 TX Primary
Registered Dietitian 133V00000X 164004392 IL

Addresses

Primary practice location

321 W Southlake Blvd
Southlake, TX 76092-6188

Mailing address

1209 Bay Meadows Dr
Southlake, TX 76092-3936
Phone (773) 882-4312

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260113003591 TX Practitioner - Registered Dietitian Or Nutrition Professional 8628554284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4801 Spring Valley Rd
Suite 20
Farmers Branch, TX 75244-8222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
164004392ILMDRegistered Dietitian
DT88105TXMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
180 Wellness, LLP Single Specialty CurrentSince Feb 1, 2026 Accepting new patients
Curis Functional Health Dietitian, Registered CurrentSince Feb 1, 2026 Accepting new patients

Locations

4801 Frankford Rd
Ste 300
Dallas, TX 75287
Phone (214) 390-3259

221 Regency Pkwy
Ste 101
Mansfield, TX 76063
Phone (817) 453-0430

321 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 337-5199

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1740502905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 BAY MEADOWS DR",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923936",
            "telephone_number": "773-882-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926188",
            "telephone_number": "817-488-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLEZAK",
        "first_name": "CARRIE",
        "middle_name": "O",
        "name_prefix": "Ms.",
        "credential": "R.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-15",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "TX",
            "license": "DT88105",
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "164004392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2025; 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.