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NPI Code Detail

MEDICARE: TERRY SCOTT TAYLOR O.D.

MEDICARE: TERRY SCOTT TAYLOR O.D.
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
1152W00000XOptometrist3855TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25073114OTHERTXAETNA PROVIDER NUMBER

General Provider Information

NPI Number : 1245273747
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY SCOTT TAYLOR O.D.
Provider Business Mailing Address
First Line : 1519 E 6TH ST
Second Line :
City : WESLACO
State : TX
Zip : 78596-6605
Country : US
Telephone Number : 956-968-3171
Fax Number : 956-968-5783
Provider Business Practice Location Address
First Line : 1519 E 6TH ST
Second Line :
City : WESLACO
State : TX
Zip : 78596-6605
Country : US
Telephone Number : 956-968-3171
Fax Number : 956-968-5783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 09/29/2016

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