Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 7196 | TX |
NPI | 1154449874 |
---|---|
Provider Name | Gregory D. Taylor |
First Address | Denton, TX 76206-0256 |
Second Address | Dallas, TX 75203-2914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U64464 | (02) | TX |