MEDICARE: KATIA 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	376G00000X	Nursing Home Administrator	37558410	TX
2	376K00000X	Nurse's Aide	NA0891200	TX

General Provider Information

NPI Number	:	1508270513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIA TAYLOR

Provider Business Mailing Address
First Line	:	3911 SOUTHERN SKY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3457
Country	:	US
Telephone Number	:	210-835-8853
Fax Number	:

Provider Business Practice Location Address
First Line	:	3911 SOUTHERN SKY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3457
Country	:	US
Telephone Number	:	210-835-8853
Fax Number	:

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

Provider Enumeration Date	:	06/17/2014
Last Update Date	:	06/17/2014

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Directions to “ KATIA TAYLOR ” Practice Location

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