Healthcare Provider Details
I. General information
NPI: 1790951457
Provider Name (Legal Business Name): CAO YING CHINESE MEDICINE & ACUPUNCTURE CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3700 W 15TH ST SUITE 230A
PLANO TX
75075-4736
US
IV. Provider business mailing address
3700 W 15TH ST SUITE 230A
PLANO TX
75075-4736
US
V. Phone/Fax
- Phone: 972-612-5256
- Fax: 972-943-8820
- Phone: 972-612-5256
- Fax: 972-943-8820
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC00728 |
| License Number State | TX |
VIII. Authorized Official
Name:
YING
CAO
Title or Position: OWNER
Credential: L. AC.
Phone: 972-612-5256