Healthcare Provider Details
I. General information
NPI: 1083805170
Provider Name (Legal Business Name): HUANGDI ACUPUNCTURE AND HERBAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3056 NORTHPARK DR
KINGWOOD TX
77339-5124
US
IV. Provider business mailing address
19118 MILLOAK DR
HUMBLE TX
77346-4004
US
V. Phone/Fax
- Phone: 281-684-9127
- Fax:
- Phone: 281-684-9127
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 00892 |
| License Number State | TX |
VIII. Authorized Official
Name:
ANNEES
GURMANI
Title or Position: L. AC
Credential: LIC. ACUPUNCTURIST
Phone: 281-684-9127