Provider Demographics
NPI:1992014831
Name:KING, TAYLOR W (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:W
Last Name:KING
Suffix:
Gender:M
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 S SONCY RD STE 140
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6406
Mailing Address - Country:US
Mailing Address - Phone:806-355-5625
Mailing Address - Fax:806-352-2245
Practice Address - Street 1:3501 S SONCY RD STE 140
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6406
Practice Address - Country:US
Practice Address - Phone:806-355-5625
Practice Address - Fax:806-352-2245
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80243231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80243OtherSTATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY