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General NPI Number Information
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NPI Number | 1033736863
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Entity Type | Individual
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Provider Name | MOLLY TAYLOR RRT
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Gender | Female
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Dates
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Enumeration Date | 06/27/2020
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Last Update Date | 06/27/2020
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Provider Practice Location Address
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Address Line | 1301 PENNSYLVANIA AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-2122
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Country | US
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Telephone | 817-250-2125
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Fax |
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Provider Business Mailing Address
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Address Line | 916 ROANOKE CT
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City | KENNEDALE
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State | TX
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Zip | 76060-2860
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Country | US
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Telephone | 817-228-1612
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2279P3900X
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Taxonomy Name | Neonatal/Pediatric Registered Respiratory Therapist
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License Number | RCP00056454
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License Number State | TX
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