MEDICARE: KARL TALAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	1069801	TX

General Provider Information

NPI Number	:	1356052195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL TALAY

Provider Business Mailing Address
First Line	:	7675 PHOENIX DR APT 922
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4716
Country	:	US
Telephone Number	:	417-227-0125
Fax Number	:

Provider Business Practice Location Address
First Line	:	7675 PHOENIX DR APT 922
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4716
Country	:	US
Telephone Number	:	417-227-0125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2022
Last Update Date	:	12/13/2022

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Directions to “ KARL TALAY ” Practice Location

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