Basic Information
| Provider Information | |||||||||
| NPI: | 1932199205 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAFF | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | V | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2005 HIGHWAY 183 N | ||||||||
| Address2: | |||||||||
| City: | EARLY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 768022188 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2546430098 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2005 NORTH 183 | ||||||||
| Address2: | |||||||||
| City: | EARLY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3256433010 | ||||||||
| FaxNumber: | 3256431063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA02883 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.