Provider Demographics
NPI:1588666226
Name:TAYLOR, LORREE (MD)
Entity type:Individual
Prefix:
First Name:LORREE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4103
Mailing Address - Country:US
Mailing Address - Phone:361-985-5533
Mailing Address - Fax:361-985-5502
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:STE 110
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-985-5533
Practice Address - Fax:361-985-5502
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049646207Q00000X
TXN4150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH002633OtherPARAMOUNT
OH0642452OtherAETNA
OH000000141251OtherANTHEM
OH01-03285OtherUHC
OH080130447OtherRRMC
OH0719100Medicaid
OH000000141251OtherANTHEM
OH0719100Medicaid