MEDICARE: CIARA JANAE TAYLOR

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	225200000X	Physical Therapy Assistant	2148393	TX

General Provider Information

NPI Number	:	1235788761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIARA JANAE TAYLOR

Provider Business Mailing Address
First Line	:	7710 W INTERSTATE 10
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-4711
Country	:	US
Telephone Number	:	210-837-4749
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 ALLEGHENY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-5004
Country	:	US
Telephone Number	:	210-837-4749
Fax Number	:

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

Provider Enumeration Date	:	09/06/2019
Last Update Date	:	09/06/2019

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Directions to “ CIARA JANAE TAYLOR ” Practice Location

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