Individual provider Active NPI

Alan Mack Taylor II, M.D.

  • Cardiovascular Disease Physician
  • Mansfield, TX
National Provider Identifier
1649272923
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
K4586 Issued in TX
Practice address
2800 E Broad St Ste 312
Mansfield, TX 76063-6412
Phone
(469) 513-2666
Fax
(469) 513-2667
NPI assigned
Jun 1, 2005
Last updated
May 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036-075421 IL
Specialist 174400000X MC09647R LA
Specialist 174400000X K4586 TX
Specialist 174400000X R6J98 MO
Specialist 174400000X 181909-1 NY
Specialist 174400000X 30929 KY
Cardiovascular Disease Physician 207RC0000X K4586 TX Primary

Addresses

Primary practice location

2800 E Broad St Ste 312
Mansfield, TX 76063-6412

Mailing address

74 Regency Pkwy
Mansfield, TX 76063-7816
Phone (817) 419-6111

Other practice location 1

74 Regency Pkwy
Mansfield, TX 76063-7816
Phone (817) 419-6111 ext. 1103

Other identifiers 1

IdentifierTypeStateIssuer
046202001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040129001171 TX Practitioner - Cardiovascular Disease (Cardiology) 8022911734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Loyola University of Chicago, Stritch School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Expense Division, Inc.Group PAC ID 4587088414, 2 clinicians
Premier Cardiovascular Care of Dallas, PLLCGroup PAC ID 5597046672, 7 clinicians

Practice addresses (Care Compare)

74 Regency Pkwy
Mansfield, TX 76063-7816
Phone (817) 419-6111

851 Hwy 287 N
Mansfield, TX 76063-2664
Phone (469) 513-2666

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-075421ILMDSpecialist
30929KYMDSpecialist
MC09647RLAMDSpecialist
R6J98MOMDSpecialist
181909-1NYMDSpecialist
K4586TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Cardiovascular Care of Dallas, PLLC Cardiovascular Disease CurrentSince Apr 1, 2024 Accepting new patients
Medvision, L.L.C. CurrentSince Jan 1, 2020 Accepting new patients
Medical Expense Division, Inc. CurrentSince Jul 15, 2020 Accepting new patients

Locations

3650 W Wheatland Rd
Ste C
Dallas, TX 75237
Phone (214) 774-9771

8144 Walnut Hill Ln
Ste 450
Dallas, TX 75231
Phone (214) 346-0602

1018 E Wheatland Rd
Duncanville, TX 75116
Phone (214) 915-8967

2800 E Broad St
Ste 312
Mansfield, TX 76063
Phone (817) 467-1990

74 Regency Pkwy
Mansfield, TX 76063
Phone (817) 419-6111

851 Highway 287 N
Mansfield, TX 76063
Phone (817) 277-3999

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11201/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/23023/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1649272923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 REGENCY PKWY",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637816",
            "telephone_number": "817-419-6111",
            "fax_number": "817-701-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST STE 312",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636412",
            "telephone_number": "469-513-2666",
            "fax_number": "469-513-2667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 Regency Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "TX",
            "postal_code": "760637816",
            "country_code": "US",
            "telephone_number": "817-419-6111 x1103",
            "fax_number": "817-701-4902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ALAN",
        "middle_name": "MACK",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-075421",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "MC09647R",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K4586",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "R6J98",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "181909-1",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "30929",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K4586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046202001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.