Healthcare Provider Details
I. General information
NPI: 1386090728
Provider Name (Legal Business Name): TAYLOR HM PHYSICIAN SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2016
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6250 HWY 83/84 AT ANTILLEY RD
ABILENE TX
79606-5215
US
IV. Provider business mailing address
200 CORPORATE BLVD
LAFAYETTE LA
70508-3870
US
V. Phone/Fax
- Phone: 325-428-1000
- Fax:
- Phone: 800-893-9698
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
A.
PAWLOWSKI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 800-893-9698