Healthcare Provider Details

I. General information

NPI: 1295987469
Provider Name (Legal Business Name): KE-HE RUAN ACUPUNCTURIST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID RUAN ACUPUNCTURIST

II. Dates (important events)

Enumeration Date: 10/18/2008
Last Update Date: 10/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6723 WESLAYAN ST
HOUSTON TX
77005-4319
US

IV. Provider business mailing address

6723 WESLAYAN ST
HOUSTON TX
77005-4319
US

V. Phone/Fax

Practice location:
  • Phone: 713-661-0849
  • Fax:
Mailing address:
  • Phone: 713-661-0849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00450
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: