Provider Demographics
NPI:1811594229
Name:LUIS G. TAYLOR, M.D. PLLC
Entity Type:Organization
Organization Name:LUIS G. TAYLOR, M.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-333-1377
Mailing Address - Street 1:3030 NORTH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702
Mailing Address - Country:US
Mailing Address - Phone:409-333-1377
Mailing Address - Fax:833-963-0868
Practice Address - Street 1:3030 NORTH STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702
Practice Address - Country:US
Practice Address - Phone:409-333-1377
Practice Address - Fax:833-963-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty