Provider Demographics
NPI:1447074091
Name:TAYLOR, SANDRA IRENE
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:IRENE
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 SUNSHINE CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2041
Mailing Address - Country:US
Mailing Address - Phone:502-762-8922
Mailing Address - Fax:
Practice Address - Street 1:2806 SUNSHINE CIR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2041
Practice Address - Country:US
Practice Address - Phone:502-762-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177207163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool