=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841593308
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. BRITTON A. TAYLOR D.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2010
-----------------------------------------------------
Last Update Date | 07/26/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 800 IRA E WOODS AVE
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-5538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-481-7025
-----------------------------------------------------
Fax | 817-481-9621
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 800 IRA E WOODS AVE
-----------------------------------------------------
City | GRAPEVINE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76051-5538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-481-7025
-----------------------------------------------------
Fax | 817-481-9621
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | DR. BRITTON ANDREW TAYLOR
-----------------------------------------------------
Credential | D,C,
-----------------------------------------------------
Telephone | 817-481-7025
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 11611
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------