Provider Demographics
NPI:1558612119
Name:GAUVAIN, TAGGART T (MD)
Entity Type:Individual
Prefix:DR
First Name:TAGGART
Middle Name:T
Last Name:GAUVAIN
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 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:713-486-7500
Mailing Address - Fax:713-512-2234
Practice Address - Street 1:11049 MEMORIAL HERMANN DR
Practice Address - Street 2:STE 200
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3773
Practice Address - Country:US
Practice Address - Phone:713-486-6000
Practice Address - Fax:713-486-6049
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4406207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361189901Medicaid