Provider Demographics
NPI:1437581998
Name:SAUCEDO, TAYLOR LEIGH (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:TAYLOR
Middle Name:LEIGH
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956-1928
Mailing Address - Country:US
Mailing Address - Phone:979-743-2108
Mailing Address - Fax:979-743-2109
Practice Address - Street 1:725 UPTON AVE
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956-1565
Practice Address - Country:US
Practice Address - Phone:979-743-2108
Practice Address - Fax:979-743-2109
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist