Provider Demographics
NPI:1902388523
Name:TAYLOR, MERIDITH
Entity Type:Individual
Prefix:
First Name:MERIDITH
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 CHICTORA CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6263
Mailing Address - Country:US
Mailing Address - Phone:512-796-9651
Mailing Address - Fax:
Practice Address - Street 1:6109 CHICTORA CV
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-6263
Practice Address - Country:US
Practice Address - Phone:512-796-9651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No376J00000XNursing Service Related ProvidersHomemaker