Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | R7612 | TX |
Y | 207YS0123X | Facial Plastic Surgeon | R7612 | TX |
NPI | 1427310176 |
---|---|
Provider Name | Dr. Christine Burke Taylor |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2012 |
Last Update Date | 31/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
388066801 | (05) | TX |
388066802 | CSHCN (01) | TX |