Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 10714 | TX |
NPI | 1164610804 |
---|---|
Provider Name | Natasha L Taylor |
First Address | Midlothian, TX 76065-1234 |
Second Address | Midlothian, TX 76065-3109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 07/11/2008 |