Provider Demographics
NPI:1356731707
Name:HAINEY, TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:HAINEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 ROCKMEAD DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2254
Mailing Address - Country:US
Mailing Address - Phone:281-348-9588
Mailing Address - Fax:281-348-2150
Practice Address - Street 1:605 ROCKMEAD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2254
Practice Address - Country:US
Practice Address - Phone:281-348-9588
Practice Address - Fax:281-348-2150
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01589500225100000X
TX1260323225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist