Provider Demographics
NPI:1275311771
Name:BIGON, TAYLOR LANE
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:LANE
Last Name:BIGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-2504
Mailing Address - Country:US
Mailing Address - Phone:979-966-8653
Mailing Address - Fax:
Practice Address - Street 1:520 W COLORADO ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-2504
Practice Address - Country:US
Practice Address - Phone:979-966-8653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other