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NPI Code Detail

MEDICARE: TAYLOR MCLISH

MEDICARE: TAYLOR MCLISH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224L00000XPedorthistCPED4595

General Provider Information

NPI Number : 1134950496
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR MCLISH
Provider Business Mailing Address
First Line : 1901 VETERANS MEMORIAL DR
Second Line :
City : TEMPLE
State : TX
Zip : 76504-7445
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 VETERANS MEMORIAL DR
Second Line :
City : TEMPLE
State : TX
Zip : 76504-7445
Country : US
Telephone Number : 254-743-2150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2024
Last Update Date : 08/09/2024

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Directions to “ TAYLOR MCLISH ” Practice Location

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