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General NPI Number Information
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NPI Number | 1265777833
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Entity Type | Organization
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Legal Business Name | TAYLORS LOVING CARE
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 12/07/2012
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Provider Practice Location Address
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Address Line | 8525 DEJA AVE
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City | AUSTIN
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State | TX
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Zip | 78747-3903
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Country | US
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Telephone | 512-689-5880
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Fax | 512-912-1842
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Provider Business Mailing Address
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Address Line | 8525 DEJA AVE
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City | AUSTIN
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State | TX
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Zip | 78747
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Country | US
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Telephone | 512-689-5880
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Fax | 512-912-1842
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Authorized Official
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Title or Position | OWNER
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Name | LATANYA ANNETTA TAYLOR
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Credential |
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Telephone | 512-689-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 18932825
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License Number State | TX
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