Provider Demographics
NPI:1285748616
Name:TAYLOR, EUGENE MADISON (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:MADISON
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2509 SCRIPTURE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2337
Mailing Address - Country:US
Mailing Address - Phone:940-898-7400
Mailing Address - Fax:940-387-7327
Practice Address - Street 1:2509 SCRIPTURE ST STE 200
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2337
Practice Address - Country:US
Practice Address - Phone:940-898-7400
Practice Address - Fax:940-387-7327
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1078207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1141020 02Medicaid
TX81H575Medicare PIN
TXC22510Medicare UPIN