MEDICARE: MS. JESSIE Z. LI O.M.D.

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	AC00012	TX

General Provider Information

NPI Number	:	1093829962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSIE Z. LI O.M.D.

Provider Business Mailing Address
First Line	:	12335 SHADOW GREEN DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-5642
Country	:	US
Telephone Number	:	281-870-8818
Fax Number	:

Provider Business Practice Location Address
First Line	:	8989 WESTHEIMER RD.
Second Line	:	STE.301
City	:	HOUSTON
State	:	TX
Zip	:	77063
Country	:	US
Telephone Number	:	713-988-8849
Fax Number	:

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	12/05/2008

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