Provider Demographics
NPI:1073963195
Name:GAYLOR, TIFFANY TALBOT (OT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:TALBOT
Last Name:GAYLOR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 HIGHWAY 6
Mailing Address - Street 2:STE D-900
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4387
Mailing Address - Country:US
Mailing Address - Phone:281-208-9200
Mailing Address - Fax:281-208-9210
Practice Address - Street 1:5425 HIGHWAY 6
Practice Address - Street 2:STE D-900
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4387
Practice Address - Country:US
Practice Address - Phone:281-208-9200
Practice Address - Fax:281-208-9210
Is Sole Proprietor?:No
Enumeration Date:2016-06-20
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist