Provider Demographics
NPI:1710718267
Name:SLADECEK, HAYLEY
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:
Last Name:SLADECEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 LCR 707
Mailing Address - Street 2:
Mailing Address - City:KOSSE
Mailing Address - State:TX
Mailing Address - Zip Code:76653-3762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19138 US HIGHWAY 281 N
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4988
Practice Address - Country:US
Practice Address - Phone:254-747-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant