Provider Demographics
NPI:1477765089
Name:TAYLOR, KENNETH R (DC)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:R
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16990 DALLAS PKWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1926
Mailing Address - Country:US
Mailing Address - Phone:972-233-2346
Mailing Address - Fax:972-733-1179
Practice Address - Street 1:16990 DALLAS PKWY
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1926
Practice Address - Country:US
Practice Address - Phone:972-233-2346
Practice Address - Fax:972-733-1179
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6394111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition