Provider Demographics
NPI:1245644335
Name:TAYLOR, KATHRYN MICHELLE (ARRT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ARRT
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Mailing Address - Street 1:1216 CATHERINE LN
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0307
Mailing Address - Country:US
Mailing Address - Phone:817-404-7653
Mailing Address - Fax:817-447-1276
Practice Address - Street 1:6491 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76132-2777
Practice Address - Country:US
Practice Address - Phone:817-887-9750
Practice Address - Fax:817-887-9753
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX3400192085R0202X, 2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology