Organization
SAFETY EXTENSIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH ANN TAYLOR (OWNER)
(512) 797-1608
Entity
Organization
Contact information
Practice address
4922 WATERFALL ST, CORPUS CHRISTI, TX 78416-1321
(512) 797-1608
(888) 662-4032
Mailing address
4922 WATERFALL ST, CORPUS CHRISTI, TX 78416-1321
(512) 797-1608
(888) 662-4032
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
515999
KS
282J00000X
Religious Nonmedical Health Care Institution
515999
KS
302F00000X
Exclusive Provider Organization
515999
KS
302R00000X
Health Maintenance Organization
515999
KS
Other
Enumeration date
12/27/2008
Last updated
12/27/2008
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