Provider Demographics
NPI:1912275298
Name:TAYLOR, DANIEL (HHP; AOS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:HHP; AOS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 N ROADRUNNER PKWY
Mailing Address - Street 2:2307
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8112
Mailing Address - Country:US
Mailing Address - Phone:661-972-6215
Mailing Address - Fax:
Practice Address - Street 1:2775 N ROADRUNNER PKWY
Practice Address - Street 2:2307
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8112
Practice Address - Country:US
Practice Address - Phone:661-972-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM7096175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath