Individual
KELLY S TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, LD, RN, CDE
Contact information
Practice address
10201 HIGHWAY 16, COMANCHE, TX 76442-4462
(254) 879-4900
(254) 879-4990
Mailing address
PO BOX 847, COMANCHE, TX 76442-0847
(254) 879-4900
(254) 879-4990
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
631418
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
631418
REGISTERED DIETICIAN LICE
TX
Enumeration date
03/02/2007
Last updated
07/08/2007
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