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General NPI Number Information
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NPI Number | 1649272923
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Entity Type | Individual
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Provider Name | ALAN MACK TAYLOR II M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2800 E BROAD ST STE 312
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City | MANSFIELD
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State | TX
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Zip | 76063-6412
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Country | US
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Telephone | 469-513-2666
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Fax | 469-513-2667
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Provider Business Mailing Address
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Address Line | 74 REGENCY PKWY
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City | MANSFIELD
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State | TX
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Zip | 76063-7816
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Country | US
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Telephone | 817-419-6111
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Fax | 817-701-4902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036-075421
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MC09647R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K4586
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | R6J98
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 181909-1
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 30929
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License Number State | KY
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Taxonomy #7
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | K4586
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License Number State | TX
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