Provider Demographics
NPI:1700567666
Name:TAYLOR, KATIE (DPT)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:LEMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1466
Mailing Address - Street 2:
Mailing Address - City:POTTSBORO
Mailing Address - State:TX
Mailing Address - Zip Code:75076-1466
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2001 N LOY LAKE RD STE J
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2837
Practice Address - Country:US
Practice Address - Phone:903-487-5520
Practice Address - Fax:903-496-0004
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1233556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist