Individual
JACQUELINE S TAYLOR ODONALD
Active
Individual
JACQUELINE S TAYLOR ODONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
E2888
AR
207R00000X
Internal Medicine Physician
Primary
L3496
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0092MN
BCBS
TX
05
—
145436001
—
AR
05
—
145871301
—
TX
01
—
5M000
BCBS
AR
01
—
DD3261
RR MEDICARE
TX
Enumeration date
11/09/2005
Last updated
11/01/2011
Update your record
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