MEDICARE: TAYLOR Y KIM PT

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	225100000X	Physical Therapist	1293145	TX

General Provider Information

NPI Number	:	1992216030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR Y KIM PT

Provider Business Mailing Address
First Line	:	5623 HAMILTON WOLFE APT 626
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4056
Country	:	US
Telephone Number	:	214-385-0273
Fax Number	:

Provider Business Practice Location Address
First Line	:	5623 HAMILTON WOLFE APT 626
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4056
Country	:	US
Telephone Number	:	214-385-0273
Fax Number	:

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

Provider Enumeration Date	:	10/17/2017
Last Update Date	:	10/17/2017

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Directions to “ TAYLOR Y KIM PT” Practice Location

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