Healthcare Provider Details

I. General information

NPI: 1437537420
Provider Name (Legal Business Name): CIPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N MACARTHUR BLVD SUITE 185
IRVING TX
75062-3691
US

IV. Provider business mailing address

3636 N MACARTHUR BLVD SUITE 185
IRVING TX
75062-3691
US

V. Phone/Fax

Practice location:
  • Phone: 972-512-8883
  • Fax:
Mailing address:
  • Phone: 214-609-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC01605
License Number StateTX

VIII. Authorized Official

Name: WEI-CHENG HUANG
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 440-391-1067