Healthcare Provider Details

I. General information

NPI: 1275101875
Provider Name (Legal Business Name): AARON HOUK TAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2021
Last Update Date: 10/12/2022
Certification Date: 10/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8201 EWING HALSELL DR FL 2
SAN ANTONIO TX
78229-3707
US

IV. Provider business mailing address

8201 EWING HALSELL DR FL 2
SAN ANTONIO TX
78229-3707
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-4837
  • Fax: 210-575-8480
Mailing address:
  • Phone: 210-575-4837
  • Fax: 210-575-8480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1043917
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1043917
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: