Individual
MISS THEA M TAYLOR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
618 W MAIN ST, #102, LEAGUE CITY, TX 77573-3773
(281) 332-4476
Mailing address
618 W MAIN ST, #102, LEAGUE CITY, TX 77573-3773
(281) 332-4476
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
10254
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8V3120
BLUE CROSS/BLUE SHEILD TX
TX
Enumeration date
04/27/2006
Last updated
07/08/2007
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