Provider Demographics
NPI:1679868004
Name:TALLANT, KAYLA MICHELL (DC)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:MICHELL
Last Name:TALLANT
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 1:3699 MCKINNEY AVE
Mailing Address - Street 2:BLDNG D, STE 404
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:972-584-1800
Mailing Address - Fax:972-408-0790
Practice Address - Street 1:3699 MCKINNEY AVE
Practice Address - Street 2:BLDNG D, STE 404
Practice Address - City:DALLA
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:972-584-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11556111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor