Provider Demographics
NPI:1659794667
Name:HAYDEN, TAYLAR BROOKE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:TAYLAR
Middle Name:BROOKE
Last Name:HAYDEN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1441 WOODSTEAD CT
Mailing Address - Street 2:SUITE 300
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-1410
Mailing Address - Country:US
Mailing Address - Phone:281-367-0400
Mailing Address - Fax:281-367-1201
Practice Address - Street 1:605 E SAN ANTONIO ST STE 520E
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6086
Practice Address - Country:US
Practice Address - Phone:361-576-0633
Practice Address - Fax:361-576-0639
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2020-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX363A00000X
TXPA08930363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant