Provider Demographics
NPI:1902019037
Name:TAYLOR, MARCIA GAY (RN, LAC)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:GAY
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RN, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 CASTLE RIDGE RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5147
Mailing Address - Country:US
Mailing Address - Phone:512-328-4041
Mailing Address - Fax:512-328-5114
Practice Address - Street 1:609 CASTLE RIDGE RD
Practice Address - Street 2:SUITE 330
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-5147
Practice Address - Country:US
Practice Address - Phone:512-328-4041
Practice Address - Fax:512-328-5114
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00836171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist