Provider Demographics
NPI:1164600037
Name:TAYLOR, SCOT (LAC)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:SCOT
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:14855 BLANCO RD STE 304
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7730
Mailing Address - Country:US
Mailing Address - Phone:210-479-3900
Mailing Address - Fax:
Practice Address - Street 1:14855 BLANCO RD STE 304
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7730
Practice Address - Country:US
Practice Address - Phone:210-479-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist