Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2082926 | TX |
NPI | 1013312792 |
---|---|
Provider Name | Crystal Taylor |
First Address | Houston, TX 77077-5394 |
Second Address | Houston, TX 77077-5394 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2014 |
Last Update Date | 24/10/2014 |