Provider Demographics
NPI:1407863277
Name:ERWIN, GEOFFREY TAYLOR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:TAYLOR
Last Name:ERWIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7301 BURNET RD
Mailing Address - Street 2:SUITE 102-219
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-2250
Mailing Address - Country:US
Mailing Address - Phone:512-576-9248
Mailing Address - Fax:855-446-0206
Practice Address - Street 1:7301 BURNET RD
Practice Address - Street 2:SUITE 102-219
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-2250
Practice Address - Country:US
Practice Address - Phone:512-576-9248
Practice Address - Fax:855-446-0206
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF3937207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100294101Medicaid
TX00TY84Medicare ID - Type UnspecifiedBLUE CROSS AND BLUE SHIEL
TXC15492Medicare UPIN