Active NPI
Paul Louis Slattery, DDS
- General Practice Dentistry
- San Antonio, TX
National Provider Identifier
1790788461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13692
- Practice address
- 8213 Roughrider Dr
San Antonio, TX 78239-2430 - Phone
- (210) 654-1633
- Fax
- (210) 654-4950
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13692 | TX | Primary |
Addresses
Primary practice location
8213 Roughrider Dr
San Antonio, TX 78239-2430
Mailing address
8213 Roughrider Dr
San Antonio, TX 78239-2430
Phone (210) 654-1633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13692 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327449600000",
"number": "1790788461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8213 ROUGHRIDER DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782392430",
"telephone_number": "210-654-1633",
"fax_number": "210-654-4950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8213 ROUGHRIDER DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782392430",
"telephone_number": "210-654-1633",
"fax_number": "210-654-4950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLATTERY",
"first_name": "PAUL",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-24",
"last_updated": "2012-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "13692",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.