Healthcare Provider Details

I. General information

NPI: 1639357221
Provider Name (Legal Business Name): BUSH BAO-XING ZHANG L.A.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10851 FERGUSON RD #A
DALLAS TX
75228-2615
US

IV. Provider business mailing address

10851 FERGUSON RD #A
DALLAS TX
75228-2615
US

V. Phone/Fax

Practice location:
  • Phone: 972-279-4888
  • Fax: 214-321-3459
Mailing address:
  • Phone: 972-279-4888
  • Fax: 214-321-3459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC000188
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: