Individual
LARRY R. TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2407 WIMBLEDON DR, ARLINGTON, TX 76017
(817) 465-3614
(817) 472-0694
Mailing address
PO BOX 173608, ARLINGTON, TX 76003-3608
(325) 675-6466
(817) 412-7020
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
227469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00SD39
BCBS
TX
05
—
109792506
—
TX
Enumeration date
05/16/2006
Last updated
08/11/2019
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