Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 13145 | TX |
NPI | 1073616421 |
---|---|
Provider Name | Dr. Charles M Taylor III |
First Address | Abilene, TX 79606 |
Second Address | Abilene, TX 79606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |