MEDICARE: RONALD JOSEPH TAYLOR MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	H0878	TX
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	H0878	TX

General Provider Information

NPI Number	:	1023091402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD JOSEPH TAYLOR MD

Provider Business Mailing Address
First Line	:	PO BOX 207012
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-7012
Country	:	US
Telephone Number	:	405-682-3303
Fax Number	:	405-384-6793

Provider Business Practice Location Address
First Line	:	21216 NORTHWEST FWY STE 560
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-4697
Country	:	US
Telephone Number	:	281-469-4939
Fax Number	:	281-469-4572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	07/21/2022

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