MEDICARE: PROF. LINYING TAN

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
2	171100000X	Acupuncturist	AC01408	TX

General Provider Information

NPI Number	:	1982078127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. LINYING TAN

Provider Business Mailing Address
First Line	:	10350 BANDERA RD # SET114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5615
Country	:	US
Telephone Number	:	210-530-1884
Fax Number	:	210-530-1224

Provider Business Practice Location Address
First Line	:	10350 BANDERA RD # SET114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5615
Country	:	US
Telephone Number	:	210-530-1884
Fax Number	:	210-530-1224

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

Provider Enumeration Date	:	11/28/2015
Last Update Date	:	08/28/2023

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