Provider Demographics
NPI:1215710702
Name:MARSHALL, TAYLOR (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 S HAMPTON RD UNIT 3082
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75123-0777
Mailing Address - Country:US
Mailing Address - Phone:214-205-1649
Mailing Address - Fax:
Practice Address - Street 1:411 N WASHINGTON AVE STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1713
Practice Address - Country:US
Practice Address - Phone:945-468-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1381803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist