Provider Demographics
NPI: | 1124213749 |
---|---|
Name: | DR. JOHN R. SLIDER AND DR. DONALD L. HEMBREE PARTNERSHIP |
Entity type: | Organization |
Organization Name: | DR. JOHN R. SLIDER AND DR. DONALD L. HEMBREE PARTNERSHIP |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OPTOMETRIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | JOHN |
Authorized Official - Middle Name: | ROBERT |
Authorized Official - Last Name: | SLIDER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 432-362-3133 |
Mailing Address - Street 1: | 4015 PENBROOK ST |
Mailing Address - Street 2: | |
Mailing Address - City: | ODESSA |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 79762-5917 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 432-361-3133 |
Mailing Address - Fax: | 432-362-4818 |
Practice Address - Street 1: | 4015 PENBROOK ST |
Practice Address - Street 2: | |
Practice Address - City: | ODESSA |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79762-5917 |
Practice Address - Country: | US |
Practice Address - Phone: | 432-361-3133 |
Practice Address - Fax: | 432-362-4818 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-09-06 |
Last Update Date: | 2007-09-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |