Provider Demographics
NPI:1073134912
Name:HINDS, TAYLOR LAUREN (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LAUREN
Last Name:HINDS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 KINSEY DR APT 1324
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3029
Mailing Address - Country:US
Mailing Address - Phone:402-416-4267
Mailing Address - Fax:
Practice Address - Street 1:411 E SE LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9633
Practice Address - Country:US
Practice Address - Phone:903-262-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9062255A2300X
TXAT76382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer