Individual
TAYLOR GILLILAND LACKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3705 MEDICAL PKWY STE 320, AUSTIN, TX 78705-1023
(512) 454-1873
(512) 371-7098
Mailing address
3705 MEDICAL PKWY, STE 320, AUSTIN, TX 78705-1023
(512) 454-1873
(512) 371-7098
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
V0788
TX
208600000X
Surgery Physician
V0788
TX
Other
Enumeration date
04/05/2018
Last updated
07/08/2024
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