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General NPI Number Information
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NPI Number | 1891654497
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Entity Type | Individual
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Provider Name | TAYLOR JAMES THOMASON
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Gender | Male
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 4505 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89154-9900
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Country | US
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Telephone | 702-774-5175
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Fax |
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Provider Business Mailing Address
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Address Line | 20 S 41ST ST APT 146
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51501-3373
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Country | US
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Telephone | 208-521-6843
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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