MEDICARE: NAAE KIM 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	AC01100	TX

General Provider Information

NPI Number	:	1922249580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAAE KIM L. AC

Provider Business Mailing Address
First Line	:	1909 CANONERO DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-2101
Country	:	US
Telephone Number	:	512-758-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 BEE CAVES RD STE 202
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6673
Country	:	US
Telephone Number	:	512-758-0614
Fax Number	:

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

Provider Enumeration Date	:	03/11/2009
Last Update Date	:	11/17/2024

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