Provider Demographics
NPI:1366653065
Name:JAMES JOHN TAYLOR DOPA
Entity Type:Organization
Organization Name:JAMES JOHN TAYLOR DOPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-575-9575
Mailing Address - Street 1:1701 E RED RIVER
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5621
Mailing Address - Country:US
Mailing Address - Phone:361-575-9575
Mailing Address - Fax:361-485-0370
Practice Address - Street 1:1701 E RED RIVER
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5621
Practice Address - Country:US
Practice Address - Phone:361-575-9575
Practice Address - Fax:361-485-0370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9432208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0014LZOtherBCBS PROVIDER ID
TX780002118OtherMEDICARE RR
TX1654311-01Medicaid
TX1654311-01Medicaid
TX8117B0Medicare PIN