Provider Demographics
NPI:1386056943
Name:SLATER-DELK MEDICAL, PLLC
Entity type:Organization
Organization Name:SLATER-DELK MEDICAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:TYREE
Authorized Official - Last Name:DELK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-212-5102
Mailing Address - Street 1:PO BOX 164
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79702-0164
Mailing Address - Country:US
Mailing Address - Phone:432-704-5661
Mailing Address - Fax:432-704-5660
Practice Address - Street 1:407 KENT ST
Practice Address - Street 2:GERALD DELK MD
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-687-2273
Practice Address - Fax:432-687-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9255207P00000X
TXM4549207P00000X
261QU0200X
TX722087363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty