Individual
TIFFANY A TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 E DAWSON ST, TYLER, TX 75701-2036
(903) 525-1913
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
M9690
TX
208M00000X
Hospitalist Physician
M9690
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295428102
—
TX
01
—
75-2616977-042
TRICARE
TX
01
—
8DD807
BCBS
TX
01
—
P01073155
RAIL ROAD
TX
Enumeration date
03/06/2012
Last updated
10/14/2014
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