Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | K8517 | TX |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | K8517 | TX |
NPI | 1043216153 |
---|---|
Provider Name | Dr. Eric Taylor JR. |
First Address | Malvern, PA 19355-0746 |
Second Address | Mcallen, TX 78503-1508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2005 |
Last Update Date | 25/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
047582403 | (05) | TX |
89651N | BCBS (01) | TX |