Provider Demographics
NPI:1902805229
Name:TAUB, LARRY R (MD)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:R
Last Name:TAUB
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5744 LBJ FWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6322
Mailing Address - Country:US
Mailing Address - Phone:972-392-2020
Mailing Address - Fax:972-387-1185
Practice Address - Street 1:5744 LBJ FWY
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6322
Practice Address - Country:US
Practice Address - Phone:972-392-2020
Practice Address - Fax:972-387-1185
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-19
Last Update Date:2023-09-21
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Provider Licenses
StateLicense IDTaxonomies
TXH7660207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF78592Medicare UPIN
TX00040RMedicare ID - Type Unspecified