Provider Demographics
NPI:1336645530
Name:TAYLOR, HAYDEN ROBERT (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:ROBERT
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:966 N GARDEN RIDGE BLVD STE 530
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-2876
Mailing Address - Country:US
Mailing Address - Phone:972-420-6605
Mailing Address - Fax:844-965-9627
Practice Address - Street 1:3501 MIDWAY RD STE 198
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8118
Practice Address - Country:US
Practice Address - Phone:972-781-2322
Practice Address - Fax:844-364-1302
Is Sole Proprietor?:No
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1301579225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist