MEDICARE: TINA TAYLOR R.D.

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	133V00000X	Registered Dietitian	DT81305	TX

General Provider Information

NPI Number	:	1588103915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA TAYLOR R.D.

Provider Business Mailing Address
First Line	:	701 MEADOW BEND CT
Second Line	:
City	:	HIGHLAND VILLAGE
State	:	TX
Zip	:	75077-8616
Country	:	US
Telephone Number	:	214-866-9765
Fax Number	:

Provider Business Practice Location Address
First Line	:	9219 GARLAND RD STE 2107
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75218-4639
Country	:	US
Telephone Number	:	866-269-4325
Fax Number	:

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

Provider Enumeration Date	:	02/17/2017
Last Update Date	:	02/17/2017

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Directions to “ TINA TAYLOR R.D.” Practice Location

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