Healthcare Provider Details

I. General information

NPI: 1669792248
Provider Name (Legal Business Name): JOSEPH TAYAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 RESEARCH BLVD STE 300
AUSTIN TX
78759-5792
US

IV. Provider business mailing address

11111 RESEARCH BLVD SUITE 300
AUSTIN TX
78759
US

V. Phone/Fax

Practice location:
  • Phone: 512-380-9200
  • Fax:
Mailing address:
  • Phone: 512-380-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberP9750
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: