Lisa Diane Taylor, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01142 Issued in TX

Practice address

59 La Costa Dr
Montgomery, TX 77356-5352

Phone

(281) 660-9499

Fax

(936) 582-5075

NPI assigned

Sep 10, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lisa.vatani@5182361698308.direct.elationemr.com

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1790110690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 LA COSTA DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773565352",
            "telephone_number": "281-660-9499",
            "fax_number": "936-582-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 LA COSTA DR",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773565352",
            "telephone_number": "281-660-9499",
            "fax_number": "936-582-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Lester Swonke, PARAMEDIC
• T Blenden Counseling & Consulting
• Laura Reynolds Tague, LCSW
• Evelyn Tamakloe
• Connie Tatroe, LMT
• Ruth N Taylor, PT
• Manga Telidevara, NP
• Tens RX, Inc.
• Sharon Veronica Terry, RN
• Texas Dental Sleep Services PLLC

• Physician Assistant in Montgomery, TX
• Providers in Montgomery, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.