Provider Demographics
NPI:1922445774
Name:TARYN J. TURNER, DO, PA
Entity Type:Organization
Organization Name:TARYN J. TURNER, DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-488-6669
Mailing Address - Street 1:901 W WALL ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7414
Mailing Address - Country:US
Mailing Address - Phone:817-488-6669
Mailing Address - Fax:817-488-6671
Practice Address - Street 1:1200 CRAWFORD AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-4561
Practice Address - Country:US
Practice Address - Phone:682-205-3501
Practice Address - Fax:682-205-3504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-03
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5025207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty