Healthcare Provider Details

I. General information

NPI: 1750297933
Provider Name (Legal Business Name): REAGAN LEA TAYLOR L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6836 AUSTIN CENTER BLVD STE 270
AUSTIN TX
78731-3151
US

IV. Provider business mailing address

2309 BERKELEY AVE APT 1121
AUSTIN TX
78745-4361
US

V. Phone/Fax

Practice location:
  • Phone: 512-454-1188
  • Fax:
Mailing address:
  • Phone: 512-680-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01712
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: