Healthcare Provider Details

I. General information

NPI: 1962463992
Provider Name (Legal Business Name): YING CAO L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
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

Practice location:
  • Phone: 972-612-5256
  • Fax: 972-943-8820
Mailing address:
  • Phone: 972-612-5256
  • Fax: 972-943-8820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC00728
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: