Healthcare Provider Details
I. General information
NPI: 1295860567
Provider Name (Legal Business Name): YANQING HUANG L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4955 DE ZAVALA RD
SAN ANTONIO TX
78249-2022
US
IV. Provider business mailing address
13710 RIDGE CHASE
SAN ANTONIO TX
78230-1189
US
V. Phone/Fax
- Phone: 210-219-7019
- Fax:
- Phone: 210-479-5462
- Fax: 210-479-5462
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC00849 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: