Individual
DR. JERRAL DEWAYNE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8440
(877) 601-5854
Mailing address
2900 E 29TH ST STE 100, BRYAN, TX 77802-2623
(979) 776-8440
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-3652
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000B40A2
—
TX
Enumeration date
11/30/2005
Last updated
07/26/2021
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