MEDICARE: RICHARD V TAFF P.A.

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	363A00000X	Physician Assistant	PA02883	TX

General Provider Information

NPI Number	:	1932199205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD V TAFF P.A.

Provider Business Mailing Address
First Line	:	2005 HIGHWAY 183 N
Second Line	:
City	:	EARLY
State	:	TX
Zip	:	76802-2188
Country	:	US
Telephone Number	:	254-643-0098
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 NORTH 183
Second Line	:
City	:	EARLY
State	:	TX
Zip	:	76802
Country	:	US
Telephone Number	:	325-643-3010
Fax Number	:	325-643-1063

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/06/2020

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