Provider Demographics
NPI:1336915578
Name:TAYLOR, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8323 SOUTHWEST FWY STE 514
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1609
Mailing Address - Country:US
Mailing Address - Phone:804-519-0688
Mailing Address - Fax:
Practice Address - Street 1:8323 SOUTHWEST FWY STE 514
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1609
Practice Address - Country:US
Practice Address - Phone:804-519-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health