Taylor, Jerral Dewayne
Taylor, Jerral Dewayne is an individual health care provider with primary practice located at 2900 E 29Th St , Bryan TX 77802-2622. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Taylor, Jerral Dewayne can be contacted via phone (979) 776-8440.Contact Information
Primary practice address
2900 E 29Th St
Bryan TX 77802-2622
Phone: (979) 776-8440
Fax: (877) 601-5854
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 2-3652 | Texas |
Profile Details
| NPI number | 1588648059 |
|---|---|
| LBN Legal business name | Taylor, Jerral Dewayne |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2005 |
| Last updated | Jul 26th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588648059 | NPPES |
| Texas | MEDICAID | P000B40A2 |
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