Provider Demographics
NPI:1073665840
Name:TAYLOR, SCOTT CHARLES (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6916 DESERT HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4592
Mailing Address - Country:US
Mailing Address - Phone:817-715-7290
Mailing Address - Fax:817-370-9772
Practice Address - Street 1:6916 DESERT HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4592
Practice Address - Country:US
Practice Address - Phone:817-715-7290
Practice Address - Fax:817-370-9772
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF00402083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine