Provider Demographics
NPI:1144792714
Name:DAVIS, TAYLOR (SLP-A)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 GRANITE VALE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-4280
Mailing Address - Country:US
Mailing Address - Phone:903-229-8379
Mailing Address - Fax:
Practice Address - Street 1:12715 TELGE RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2289
Practice Address - Country:US
Practice Address - Phone:903-229-8379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX405732355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant