Healthcare Provider Details

I. General information

NPI: 1982944930
Provider Name (Legal Business Name): DAPHNE ACUPUNCTURE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8512 KENNING CT
PLANO TX
75024-7301
US

IV. Provider business mailing address

4101 W SPRING CREEK PKWY STE 200
PLANO TX
75024-5204
US

V. Phone/Fax

Practice location:
  • Phone: 469-328-3680
  • Fax:
Mailing address:
  • Phone: 469-328-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1341
License Number StateTX

VIII. Authorized Official

Name: MS. DAPHNE SU
Title or Position: MANAGER
Credential: L.AC
Phone: 469-328-3680