Provider Demographics
NPI:1689341992
Name:TAYLOR, WINONA KATHLEEN (PHARMACY TECHNIIAN)
Entity Type:Individual
Prefix:
First Name:WINONA
Middle Name:KATHLEEN
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARMACY TECHNIIAN
Other - Prefix:
Other - First Name:NONI
Other - Middle Name:KATHLEEN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:12018 PERRIN BEITEL RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-2116
Mailing Address - Country:US
Mailing Address - Phone:210-655-9542
Mailing Address - Fax:210-655-9590
Practice Address - Street 1:12018 PERN BETL RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-2198
Practice Address - Country:US
Practice Address - Phone:210-655-9542
Practice Address - Fax:210-655-9590
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135129183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician