MEDICARE: TAYLOR BROOKE LEDOUX

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	363LF0000X	Family Nurse Practitioner	1022684	TX

General Provider Information

NPI Number	:	1669347365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR BROOKE LEDOUX

Provider Business Mailing Address
First Line	:	2584 STATE HIGHWAY 124
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-7889
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2584 STATE HIGHWAY 124
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-7889
Country	:	US
Telephone Number	:	409-296-4444
Fax Number	:

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

Provider Enumeration Date	:	10/10/2025
Last Update Date	:	11/04/2025

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Directions to “ TAYLOR BROOKE LEDOUX ” Practice Location

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