Provider Demographics
NPI:1558556381
Name:RONALD J. TAYLOR MD PA
Entity Type:Organization
Organization Name:RONALD J. TAYLOR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-469-3949
Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE 560
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4695
Mailing Address - Country:US
Mailing Address - Phone:281-469-3949
Mailing Address - Fax:281-469-4572
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 560
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4695
Practice Address - Country:US
Practice Address - Phone:281-469-3949
Practice Address - Fax:281-469-4572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0878207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U33HMedicare PIN
TX00H12SMedicare PIN