Basic Information
| Provider Information | |||||||||
| NPI: | 1053582874 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | DAVIDSON | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.S., CCC/A | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DAVIDSON | ||||||||
| OtherFirstName: | CHERYL | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.S., CCC/A | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1966 INWOOD RD. | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752357298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149053000 | ||||||||
| FaxNumber: | 2149053022 | ||||||||
| Practice Location | |||||||||
| Address1: | 1966 INWOOD RD. | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752357298 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2149053000 | ||||||||
| FaxNumber: | 2149053022 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2008 | ||||||||
| LastUpdateDate: | 09/17/2012 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 50946 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 50946 | TX | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.