MEDICARE: THOMAS E. TAYLOR, M.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
1	174400000X	Specialist	C8465	TX

General Provider Information

NPI Number	:	1912018797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS E. TAYLOR, M.D.

Provider Business Mailing Address
First Line	:	1500 BROOK AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-5604
Country	:	US
Telephone Number	:	940-766-4365
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 BROOK AVE
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76301-5604
Country	:	US
Telephone Number	:	940-766-4365
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS E TAYLOR
Credential	:	M.D.
Telephone Number	:	940-766-4365

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	10/24/2007

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