Individual
DR. ROOSEVELT TAYLOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9209 ELAM RD STE 100, ROOSEVELT TAYLOR JR MD, DALLAS, TX 75217-7360
(214) 391-3700
(214) 391-7195
Mailing address
9209 ELAM RD STE 100, ROOSEVELT TAYLOR JR MD, DALLAS, TX 75217-7360
(214) 391-3700
(214) 391-7195
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D9896
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00M973
BLUE CROSS BLUE SHIELD
—
05
—
121397702
—
TX
Enumeration date
12/01/2006
Last updated
01/19/2010
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