Provider Demographics
NPI:1780614248
Name:TAYLOR, EDWARD E (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:E
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3409 JUNIUS ST.
Mailing Address - Street 2:CS11 G006
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-2026
Mailing Address - Country:US
Mailing Address - Phone:214-821-1599
Mailing Address - Fax:
Practice Address - Street 1:2710 SWISS AVENUE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-5900
Practice Address - Country:US
Practice Address - Phone:214-821-1599
Practice Address - Fax:214-821-8985
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM76812086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
I32062Medicare UPIN