Healthcare Provider Details

I. General information

NPI: 1982793501
Provider Name (Legal Business Name): WEISHAN KUO MASTER OF ACUPUNCTUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 RAWHIDE DR STE 402
ROUND ROCK TX
78681-6953
US

IV. Provider business mailing address

15204 ROSEHIP LN
PFLUGERVILLE TX
78660-3096
US

V. Phone/Fax

Practice location:
  • Phone: 512-244-7888
  • Fax: 512-244-7888
Mailing address:
  • Phone: 512-638-2168
  • Fax: 512-244-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberLAC00824
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: