Provider Demographics
NPI:1972200517
Name:FREI, TAYLOR (PT, DPT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:FREI
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 1:4900 SANGER AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5866
Mailing Address - Country:US
Mailing Address - Phone:254-848-6284
Mailing Address - Fax:254-848-4193
Practice Address - Street 1:578 S WHEAT RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-7134
Practice Address - Country:US
Practice Address - Phone:254-598-2620
Practice Address - Fax:254-848-4193
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
TX1373903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics