Provider Demographics
NPI:1285356485
Name:TAYLOR, TYREE
Entity type:Individual
Prefix:
First Name:TYREE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ST JAMES WAY
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9970
Mailing Address - Country:US
Mailing Address - Phone:214-893-4902
Mailing Address - Fax:
Practice Address - Street 1:310 ST JAMES WAY
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9970
Practice Address - Country:US
Practice Address - Phone:214-893-4902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver
No342000000XTransportation ServicesTransportation Network Company
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker