MEDICARE: DOUGLAS E TAYLOR

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	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	247200000X	OTHER	TX	VETERANS AFFAIRS

General Provider Information

NPI Number	:	1649596842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS E TAYLOR

Provider Business Mailing Address
First Line	:	7329 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4805
Country	:	US
Telephone Number	:	713-794-7922
Fax Number	:	713-791-1010

Provider Business Practice Location Address
First Line	:	7329 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4805
Country	:	US
Telephone Number	:	713-794-7922
Fax Number	:	713-791-1010

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

Provider Enumeration Date	:	04/13/2010
Last Update Date	:	04/13/2010

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Directions to “ DOUGLAS E TAYLOR ” Practice Location

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