Taylor, Ethan

Taylor, Ethan is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Taylor, Ethan can be contacted via phone (903) 606-4522.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 606-4522
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 853309 Texas
Nursing Service Providers / Registered Nurse 163W00000X RN139391 Louisiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP132890 Texas

Profile Details

NPI number 1255876348
LBN Legal business name Taylor, Ethan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2016
Last updated Apr 30th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255876348 NPPES
Texas MEDICAID 367663705
Texas Other 8LX980

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