Individual
TERRY D TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
6560 FANNIN ST, STE 614, HOUSTON, TX 77030-2727
(713) 790-1995
(713) 790-9562
Mailing address
6560 FANNIN ST, STE 614, HOUSTON, TX 77030-2727
(713) 790-1995
(713) 790-9562
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
13953
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
13953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135026603
—
TX
01
—
135026604
CIDC ID
TX
01
—
D13953
BCBS ID
TX
Enumeration date
06/01/2005
Last updated
09/02/2020
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