Healthcare Provider Details

I. General information

NPI: 1609344712
Provider Name (Legal Business Name): TAYLOR URANGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 NE LOOP 410
SAN ANTONIO TX
78217-5600
US

IV. Provider business mailing address

2391 NE LOOP 410 STE 304
SAN ANTONIO TX
78217-5675
US

V. Phone/Fax

Practice location:
  • Phone: 210-591-8999
  • Fax:
Mailing address:
  • Phone: 719-540-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: