Provider Demographics
NPI:1225232465
Name:TAYLOR, WILLIS JOHN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIS
Middle Name:JOHN
Last Name:TAYLOR
Suffix:JR
Gender:M
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 74
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0074
Mailing Address - Country:US
Mailing Address - Phone:832-419-0381
Mailing Address - Fax:
Practice Address - Street 1:6660 AIRLINE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-3512
Practice Address - Country:US
Practice Address - Phone:713-697-8000
Practice Address - Fax:713-697-7111
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor