Provider Demographics
NPI:1073654984
Name:TALOSIG, VINCENT (DO)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:TALOSIG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 MORRISON DR.
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033
Mailing Address - Country:US
Mailing Address - Phone:630-915-6302
Mailing Address - Fax:281-440-6205
Practice Address - Street 1:17270 RED OAK DR STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090
Practice Address - Country:US
Practice Address - Phone:281-440-6960
Practice Address - Fax:281-440-6205
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA876872081P2900X, 208100000X
TXN6704207LP2900X, 2081P2900X
MDP21526208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP21526Medicare UPIN
TXTXB162345Medicare PIN