Provider Demographics
NPI:1427240084
Name:TAYLOR, GARY W (LBSW)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:W
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 HARVEST HILL LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1384
Mailing Address - Country:US
Mailing Address - Phone:214-673-2497
Mailing Address - Fax:469-533-6450
Practice Address - Street 1:1138 HARVEST HILL LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1384
Practice Address - Country:US
Practice Address - Phone:214-673-2497
Practice Address - Fax:469-533-6450
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator