Provider Demographics
NPI:1134311400
Name:TAYLOR, JOSEPH OSCAR JR (APNFA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:OSCAR
Last Name:TAYLOR
Suffix:JR
Gender:M
Credentials:APNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 NE LOOP 410
Mailing Address - Street 2:STE 850
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5824
Mailing Address - Country:US
Mailing Address - Phone:210-352-5346
Mailing Address - Fax:210-352-5367
Practice Address - Street 1:23103 IH 10 W STE 105
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1766
Practice Address - Country:US
Practice Address - Phone:210-538-6030
Practice Address - Fax:210-538-7737
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654945163WR0006X
TXAP115928363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2176653-03Medicaid
TX758659OtherMEDICARE PTAN
TX8206NL-SASAOtherBCBSTX
TX217665302-SASAMedicaid
TX11790127OtherCAQH
TX8206NLOtherBCBS (SASA)
TX11790127OtherCAQH
TX363654 ZKP8OtherSASA
TX363654 ZKP9OtherSASA
TXP01415800OtherSASA
TX8L12834Medicare PIN
TX363654ZKP9Medicare PIN