Healthcare Provider Details

I. General information

NPI: 1902085715
Provider Name (Legal Business Name): RACHEL JUMPER TAYLOR PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 N FLOYD RD STE 5
RICHARDSON TX
75080-4243
US

IV. Provider business mailing address

1112 N FLOYD RD STE 5
RICHARDSON TX
75080-4243
US

V. Phone/Fax

Practice location:
  • Phone: 972-952-0280
  • Fax: 972-852-6005
Mailing address:
  • Phone: 972-952-0280
  • Fax: 972-852-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA08589
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1669
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: