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General NPI Number Information
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NPI Number | 1215584644
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Entity Type | Organization
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Legal Business Name | BOCANGEL INTEGRATIVE MEDICINE & ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 7122 SAN PEDRO AVE STE 106
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City | SAN ANTONIO
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State | TX
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Zip | 78216-6233
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Country | US
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Telephone | 210-967-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 100 LORENZ RD APT 404
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2539
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANDRA MEDINA BOCANGEL
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Credential | LAC
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Telephone | 512-809-5430
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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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