Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | ||
N | 225000000X | Orthotic Fitter |
NPI | 1730325887 |
---|---|
Provider Name | Douglas A Taylor |
First Address | Live Oak, TX 78233-3277 |
Second Address | Live Oak, TX 78233-3277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2008 |
Last Update Date | 19/12/2008 |