Healthcare Provider Details

I. General information

NPI: 1487822821
Provider Name (Legal Business Name): BALANCE ACUPUNCTURE AND HERBS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2008
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14855 BLANCO RD STE 304
SAN ANTONIO TX
78216-7730
US

IV. Provider business mailing address

14855 BLANCO RD STE 304
SAN ANTONIO TX
78216-7730
US

V. Phone/Fax

Practice location:
  • Phone: 210-479-3900
  • Fax: 210-479-3906
Mailing address:
  • Phone: 210-479-3900
  • Fax: 210-479-3906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SCOT TAYLOR
Title or Position: OWNER
Credential: LAC
Phone: 210-479-3900