Provider Demographics
NPI:1790452340
Name:TAYLOR, BRIAN D (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:223 E HILDEBRAND AVE STE 105B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2888
Mailing Address - Country:US
Mailing Address - Phone:281-783-8162
Mailing Address - Fax:281-895-3083
Practice Address - Street 1:223 E HILDEBRAND AVE STE 105B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-2888
Practice Address - Country:US
Practice Address - Phone:281-783-8162
Practice Address - Fax:281-895-3083
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA14914363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant