Provider Demographics
NPI:1881347292
Name:PIACENTE, TAYLOR RENEE (DPT, PT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:RENEE
Last Name:PIACENTE
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 DELANO AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2851 MATLOCK RD STE 600
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5039
Practice Address - Country:US
Practice Address - Phone:817-473-6246
Practice Address - Fax:817-473-2014
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1315737225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist