Provider Demographics
NPI:1568701464
Name:TAYLOR, MATTHEW FORD (DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:FORD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 S MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-7037
Mailing Address - Country:US
Mailing Address - Phone:817-898-7090
Mailing Address - Fax:
Practice Address - Street 1:821 E NORTHWEST HWY STE 300
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3306
Practice Address - Country:US
Practice Address - Phone:817-203-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-12
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist