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NPI Code Detail

MEDICARE: DR. TAYLOR KONZE ROBISON DDS

MEDICARE: DR. TAYLOR KONZE ROBISON DDS
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
11223G0001XGeneral Practice Dentistry33160TX

General Provider Information

NPI Number : 1093235574
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAYLOR KONZE ROBISON DDS
Provider Business Mailing Address
First Line : 360 NUECES ST APT 2107
Second Line :
City : AUSTIN
State : TX
Zip : 78701-4267
Country : US
Telephone Number : 512-925-1095
Fax Number :
Provider Business Practice Location Address
First Line : 401 W SLAUGHTER LN STE 200
Second Line :
City : AUSTIN
State : TX
Zip : 78748-1774
Country : US
Telephone Number : 512-291-8012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2017
Last Update Date : 06/26/2017

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