MEDICARE: SIERRA SKYE DEE L.AC

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	171100000X	Acupuncturist	AC02164	TX

General Provider Information

NPI Number	:	1093552036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA SKYE DEE L.AC

Provider Business Mailing Address
First Line	:	4108 SUN SPIRIT DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-6365
Country	:	US
Telephone Number	:	252-349-6099
Fax Number	:

Provider Business Practice Location Address
First Line	:	9217 W US HIGHWAY 290 STE 150
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78736-7818
Country	:	US
Telephone Number	:	512-522-8488
Fax Number	:

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

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	01/06/2025

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