Individual
TOLLESON C TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 7TH AVE, FORT WORTH, TX 76104-2722
(682) 885-1050
(682) 885-7572
Mailing address
PO BOX 99371, FORT WORTH, TX 76199-0371
(682) 885-1855
(682) 885-7347
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
M4584
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
M4584
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750369203
NPI GROUP NUMBER
TX
Enumeration date
01/24/2007
Last updated
05/19/2016
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