Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | H0878 | TX |
N | 111NI0900X | Internist | H0878 | TX |
Y | 207RG0300X | Geriatric Medicine | H0878 | TX |
NPI | 1023091402 |
---|---|
Provider Name | Ronald Joseph Taylor |
First Address | Dallas, TX 75320-7012 |
Second Address | Cypress, TX 77429-4697 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 13/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D86943 | (02) | TX |