Provider Demographics
NPI:1750869582
Name:TEMPLIN, TAYLOR L
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:L
Last Name:TEMPLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 TRINITY CIR APT 3015
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2116
Mailing Address - Country:US
Mailing Address - Phone:817-575-7272
Mailing Address - Fax:
Practice Address - Street 1:709 TRINITY CIR APT 3015
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2116
Practice Address - Country:US
Practice Address - Phone:817-575-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program