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Individual

DR. MOIRAE MICHELLE TAYLOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4343 N JOSEY LN, CARROLLTON, TX 75010-4603
(972) 394-2412
(972) 394-2328
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
K5714
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
14678803
TX
05
146788801
TX
05
146788806
TX
05
146788807
TX
01
146788808
MEDICAID CSHCN
TX
05
146788809
TX
01
146788810
MEDICAID CSHCN
TX
01
8B1132
BCBS
TX
Enumeration date
12/19/2005
Last updated
05/21/2014
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