Provider Demographics
NPI:1164610804
Name:TAYLOR, NATASHA L (DC)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:L
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-1234
Mailing Address - Country:US
Mailing Address - Phone:972-775-5330
Mailing Address - Fax:972-775-5480
Practice Address - Street 1:107 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-3109
Practice Address - Country:US
Practice Address - Phone:972-775-5330
Practice Address - Fax:972-775-5480
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10714111NN0400X
133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education