Provider Demographics
NPI:1467541664
Name:TAYYABA, TALAT (MD)
Entity Type:Individual
Prefix:DR
First Name:TALAT
Middle Name:
Last Name:TAYYABA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 SPECTRUM BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-9705
Mailing Address - Country:US
Mailing Address - Phone:214-927-8018
Mailing Address - Fax:817-684-0406
Practice Address - Street 1:3417 SPECTRUM BLVD STE 200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-9705
Practice Address - Country:US
Practice Address - Phone:972-478-0322
Practice Address - Fax:972-907-1187
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMPORARY2084P0804X
KST-009252084P0804X
TXM83792084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM8379OtherMEDICAL LICENSE