Healthcare Provider Details

I. General information

NPI: 1053051821
Provider Name (Legal Business Name): RUI HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 LEGACY DR STE 200
FRISCO TX
75034-6283
US

IV. Provider business mailing address

3010 LEGACY DR STE 200
FRISCO TX
75034-6283
US

V. Phone/Fax

Practice location:
  • Phone: 972-467-0887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01900
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: