MEDICARE: ALICIA TAYLOR OD

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
1	152W00000X	Optometrist	11189	TX

General Provider Information

NPI Number	:	1912740549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA TAYLOR OD

Provider Business Mailing Address
First Line	:	150 FM 460 STE 100
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-4432
Country	:	US
Telephone Number	:	469-728-0066
Fax Number	:	469-728-0067

Provider Business Practice Location Address
First Line	:	150 FM 460 STE 100
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-4432
Country	:	US
Telephone Number	:	214-326-6542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	06/04/2026

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Directions to “ ALICIA TAYLOR OD” Practice Location

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