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General NPI Number Information
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NPI Number | 1144862475
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Entity Type | Organization
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Legal Business Name | TEXAS HEALTH AND SCIENCE UNIVERSITY
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Dates
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Enumeration Date | 10/08/2019
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 1707 FORTVIEW RD
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City | AUSTIN
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State | TX
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Zip | 78704-7620
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Country | US
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Telephone | 512-912-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 4005 MANCHACA RD
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City | AUSTIN
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State | TX
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Zip | 78704-6737
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Country | US
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Telephone | 512-444-8082
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Fax |
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | JUE GONG
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Credential |
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Telephone | 504-919-7353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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