Provider Demographics
NPI:1548044373
Name:BEAN, TAYLOR (MOT)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:BEAN
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11070 KATY FWY APT 1209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4761
Mailing Address - Country:US
Mailing Address - Phone:832-768-4171
Mailing Address - Fax:
Practice Address - Street 1:2929 POST OAK BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6120
Practice Address - Country:US
Practice Address - Phone:713-993-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120410225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist