Provider Demographics
NPI:1649596842
Name:TAYLOR, DOUGLAS E
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4805
Mailing Address - Country:US
Mailing Address - Phone:713-794-7922
Mailing Address - Fax:713-791-1010
Practice Address - Street 1:7329 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4805
Practice Address - Country:US
Practice Address - Phone:713-794-7922
Practice Address - Fax:713-791-1010
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX247200000XOtherVETERANS AFFAIRS