Provider Demographics
NPI:1326050956
Name:TAYLOR, DAVID H (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 LAMAR AVE STE K
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4460
Mailing Address - Country:US
Mailing Address - Phone:903-784-2211
Mailing Address - Fax:903-784-2475
Practice Address - Street 1:707 LAMAR AVE STE K
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4460
Practice Address - Country:US
Practice Address - Phone:903-784-2211
Practice Address - Fax:903-784-2475
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5015174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113600401Medicaid
TXD26875Medicare UPIN
TX00596LMedicare PIN