MEDICARE: DR. BRENDEN ELIZABETH TAYLOR DDS

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	122300000X	Dentist	26125	TX

General Provider Information

NPI Number	:	1427344555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENDEN ELIZABETH TAYLOR DDS

Provider Business Mailing Address
First Line	:	4713 JACKSON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5037
Country	:	US
Telephone Number	:	972-352-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	5252 WESTCHESTER ST
Second Line	:	STE 190
City	:	HOUSTON
State	:	TX
Zip	:	77005-4141
Country	:	US
Telephone Number	:	713-666-7884
Fax Number	:

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

Provider Enumeration Date	:	06/27/2011
Last Update Date	:	09/10/2015

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