MEDICARE: MRS. KUN ZHAO 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	AC00643	TX

General Provider Information

NPI Number	:	1235309642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KUN ZHAO L. AC.

Provider Business Mailing Address
First Line	:	7434 LOUIS PASTEUR DR STE 108
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4539
Country	:	US
Telephone Number	:	210-471-1828
Fax Number	:	210-614-8686

Provider Business Practice Location Address
First Line	:	7434 LOUIS PASTEUR DR STE 108
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4539
Country	:	US
Telephone Number	:	210-471-1828
Fax Number	:	210-614-8686

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

Provider Enumeration Date	:	03/03/2008
Last Update Date	:	03/03/2008

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