Basic Information
Provider Information
NPI: 1366440828
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAYLOR
FirstName: WILLIAM
MiddleName: PEYTON
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4700 SETON CENTER PKWY
Address2: SUITE 200
City: AUSTIN
State: TX
PostalCode: 787595295
CountryCode: US
TelephoneNumber: 5124391000
FaxNumber: 5124391081
Practice Location
Address1: 4700 SETON CENTER PKWY
Address2: SUITE 200
City: AUSTIN
State: TX
PostalCode: 787595295
CountryCode: US
TelephoneNumber: 5124391000
FaxNumber: 5124391081
Other Information
ProviderEnumerationDate: 07/08/2005
LastUpdateDate: 06/16/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0117XD5229TXY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
207X00000XD5229TXN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
20001908601 MEDICARE RAILROADOTHER
13413720805TX MEDICAID


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