Provider Demographics
NPI:1568748721
Name:TAYLOR, PHILLIP DAVID SR (MPAS, PA-C)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:DAVID
Last Name:TAYLOR
Suffix:SR
Gender:M
Credentials:MPAS, PA-C
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Mailing Address - Street 1:204 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4822
Mailing Address - Country:US
Mailing Address - Phone:361-664-0145
Mailing Address - Fax:361-664-2248
Practice Address - Street 1:1210 N RETAMA ST
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78363-3496
Practice Address - Country:US
Practice Address - Phone:361-239-0600
Practice Address - Fax:877-550-1895
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2025-08-01
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Provider Licenses
StateLicense IDTaxonomies
TXPA07458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical