Individual
SUSAN JANE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1301 AVENUE G, DEL RIO, TX 78840-3627
(830) 775-5800
Mailing address
PO BOX 1315, DEL RIO, TX 78841-1315
(830) 775-5800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E6969
TX
207RH0000X
Hematology (Internal Medicine) Physician
E6969
TX
207RX0202X
Medical Oncology Physician
Primary
E6968
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225260 (07)
—
TX
01
—
8P5870
BCBS INDIVIDUAL NUMBER
TX
01
—
P00175170
RR MEDICARE INDIVIDUAL #
TX
Enumeration date
08/01/2006
Last updated
03/09/2023
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