Provider Demographics
NPI:1750333225
Name:TAYLOR, RICHARD MCLAREN (DO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MCLAREN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1920 S LOOP 256
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801
Mailing Address - Country:US
Mailing Address - Phone:903-731-9599
Mailing Address - Fax:903-731-4202
Practice Address - Street 1:151 ASHLEY DRIVE
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028
Practice Address - Country:US
Practice Address - Phone:830-792-4805
Practice Address - Fax:830-792-4883
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K2530OtherBLUE CROSS/BLUE SHIELD
F83501Medicare UPIN
TX8C0881Medicare PIN