Organization
OMS PHYSICIANS GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY DAVID TAYLOR DDS, M.D. (OWNER)
(817) 424-1166
Entity
Organization
Contact information
Practice address
1422 MAIN ST, SUITE 240, SOUTHLAKE, TX 76092-7625
(817) 424-1166
Mailing address
1422 MAIN ST, SUITE 240, SOUTHLAKE, TX 76092-7625
(817) 424-1166
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H87528
UPIN
TX
Enumeration date
06/23/2009
Last updated
06/23/2009
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