Provider Demographics
NPI:1912931213
Name:TAYLOR, TARA LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:LEIGH
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:618 S BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1665
Mailing Address - Country:US
Mailing Address - Phone:903-596-9900
Mailing Address - Fax:903-596-0242
Practice Address - Street 1:618 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1665
Practice Address - Country:US
Practice Address - Phone:903-596-9900
Practice Address - Fax:903-596-0242
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM5538207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease