Provider Demographics
NPI:1356454292
Name:TAYLOR, THOMAS VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VINCENT
Last Name:TAYLOR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1315 ST JOSEPH PKWY
Mailing Address - Street 2:1111
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8233
Mailing Address - Country:US
Mailing Address - Phone:713-654-8113
Mailing Address - Fax:713-654-8889
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:1111
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-654-8113
Practice Address - Fax:713-654-8889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-04-30
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Provider Licenses
StateLicense IDTaxonomies
TXK2297207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1025280-03Medicaid
TXG30080Medicare UPIN