MEDICARE: DR. WILLIS JOHN TAYLOR JR. D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7197	TX

General Provider Information

NPI Number	:	1225232465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIS JOHN TAYLOR JR. D.C.

Provider Business Mailing Address
First Line	:	PO BOX 74
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77402-0074
Country	:	US
Telephone Number	:	832-419-0381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6660 AIRLINE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-3512
Country	:	US
Telephone Number	:	713-697-8000
Fax Number	:	713-697-7111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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