Provider Demographics
NPI:1326447376
Name:TAYLOR, JOE ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:ROBERT
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 1:5509 ATTWATER AVE
Mailing Address - Street 2:CAROLE YOUNG MEDICAL FACILITY
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-4157
Mailing Address - Country:US
Mailing Address - Phone:409-948-0001
Mailing Address - Fax:409-945-3758
Practice Address - Street 1:5509 ATTWATER AVE
Practice Address - Street 2:CAROLE YOUNG MEDICAL FACILITY
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-4157
Practice Address - Country:US
Practice Address - Phone:409-948-0001
Practice Address - Fax:409-945-3758
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine