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Individual

KENT ALAN TAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
613 FAIRWAY VIEW TER, SOUTHLAKE, TX 76092-9550
(214) 649-1444
Mailing address
613 FAIRWAY VIEW TER, SOUTHLAKE, TX 76092-9550
(214) 649-1444

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J6042
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
138767225
TX
01
8AB544
BCBSTX
TX
01
P00759870
RAILROAD MEDICARE THRU HEB
TX
Enumeration date
08/18/2006
Last updated
02/01/2010
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