H. Sprague Taveau IV DO PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

J0696 Issued in TX

Legal business name

H. SPRAGUE TAVEAU IV DO PA

Practice address

2300 S Clear Creek Rd
Suite 101
Killeen, TX 76549-4984

Phone

(855) 963-4325

Fax

(855) 963-4325

NPI assigned

Oct 3, 2006

Last updated

May 16, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Horatio Sprague Taveau IV, DO

Title

Owner

Phone

(855) 963-4325

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1306930250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 S CLEAR CREEK RD",
            "address_2": "SUITE 101",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494984",
            "telephone_number": "855-963-4325",
            "fax_number": "855-963-4325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 S CLEAR CREEK RD",
            "address_2": "SUITE 101",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765494984",
            "telephone_number": "855-963-4325",
            "fax_number": "855-963-4325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H. SPRAGUE TAVEAU IV DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "TAVEAU",
        "authorized_official_first_name": "HORATIO",
        "authorized_official_middle_name": "SPRAGUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-963-4325",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "J0696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140005324",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Killeen, TX
• Providers in Killeen, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.