Provider Demographics
NPI:1720312952
Name:TAYLOR, SWANITA (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:SWANITA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 LAVERNE ST
Mailing Address - Street 2:SUITE# 311
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-6700
Mailing Address - Country:US
Mailing Address - Phone:832-267-6386
Mailing Address - Fax:713-647-0501
Practice Address - Street 1:8801 HAMMERLY BLVD
Practice Address - Street 2:SUITE# 1803
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-6508
Practice Address - Country:US
Practice Address - Phone:832-267-6386
Practice Address - Fax:713-647-0501
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15099425376J00000X, 171M00000X, 174400000X, 372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker
No174400000XOther Service ProvidersSpecialist
No372500000XNursing Service Related ProvidersChore Provider