Healthcare Provider Details

I. General information

NPI: 1700109741
Provider Name (Legal Business Name): ASYA KAREEM AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2010
Last Update Date: 03/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5866 S STAPLES ST SUITE 401
CORPUS CHRISTI TX
78413-3700
US

IV. Provider business mailing address

5866 S STAPLES ST SUITE 401
CORPUS CHRISTI TX
78413-3700
US

V. Phone/Fax

Practice location:
  • Phone: 361-991-7884
  • Fax: 361-991-7883
Mailing address:
  • Phone: 361-991-7884
  • Fax: 361-991-7883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00364
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: