Provider Demographics
NPI:1093400814
Name:TRAN, TAYLOR TAM (AUD)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:TAM
Last Name:TRAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 PAESANOS PKWY STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1255
Mailing Address - Country:US
Mailing Address - Phone:210-479-4327
Mailing Address - Fax:
Practice Address - Street 1:3619 PAESANOS PKWY STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1255
Practice Address - Country:US
Practice Address - Phone:210-479-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA14035237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter