Provider Demographics
NPI:1679745244
Name:KREIPE BUENSALIDO, TARYN MARGARET (DC)
Entity Type:Individual
Prefix:DR
First Name:TARYN
Middle Name:MARGARET
Last Name:KREIPE BUENSALIDO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 COUNTRY ROAD 306 BUILDING 3300
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-4001
Mailing Address - Country:US
Mailing Address - Phone:512-598-1223
Mailing Address - Fax:
Practice Address - Street 1:200 COUNTRY ROAD 306 BUILDING 3300
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-7653
Practice Address - Country:US
Practice Address - Phone:512-598-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30858111N00000X
TX15169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor