Provider Demographics
NPI:1386693752
Name:SLADE, STEPHEN GLENN (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:GLENN
Last Name:SLADE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3900 ESSEX LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5133
Mailing Address - Country:US
Mailing Address - Phone:713-626-5544
Mailing Address - Fax:713-626-7744
Practice Address - Street 1:3900 ESSEX LN
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5133
Practice Address - Country:US
Practice Address - Phone:713-626-5544
Practice Address - Fax:713-626-7744
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-08-24
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Provider Licenses
StateLicense IDTaxonomies
TXF7175207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC21885Medicare UPIN
TXTXB145212Medicare UPIN