Individual provider Active NPI

Terry D Taylor, DDS MS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Houston, TX
National Provider Identifier
1891797130
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
13953 Issued in TX
Practice address
6560 Fannin St
Ste 614
Houston, TX 77030-2727
Phone
(713) 790-1995
Fax
(713) 790-9562
NPI assigned
Jun 1, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 13953 TX Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 13953 TX

Addresses

Primary practice location

6560 Fannin St
Ste 614
Houston, TX 77030-2727

Mailing address

6560 Fannin St
Ste 614
Houston, TX 77030-2727
Phone (713) 790-1995

Other identifiers 3

IdentifierTypeStateIssuer
135026604OtherTXCIDC ID
135026603MedicaidTX
D13953OtherTXBCBS ID

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.
Opted out of Medicare
Yes, effective Oct 1, 2026 through Oct 1, 2028

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110506000207 TX Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 8527243567 Reassigns benefits to 2 organizations
Practice locations: Houston, TX

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13953TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince May 1, 2012 Accepting new patients
Lighthouse Surgical Holdings PLLC Oral and Maxillofacial Surgery CurrentSince Oct 1, 2021 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

6560 Fannin St
Ste 614
Houston, TX 77030
Phone (713) 790-1995

Interoperability endpoints

  • Direct secure messaging: ttaylor32263@directhoustonmethodist.org

Organizations & group practices 2

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

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": "1599004800000",
    "number": "1891797130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "STE 614",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302727",
            "telephone_number": "713-790-1995",
            "fax_number": "713-790-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST",
            "address_2": "STE 614",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302727",
            "telephone_number": "713-790-1995",
            "fax_number": "713-790-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TERRY",
        "middle_name": "D",
        "credential": "DDS  MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "13953",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "13953",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIDC ID",
            "identifier": "135026604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135026603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "D13953",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.