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General NPI Number Information
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NPI Number | 1316103690
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Entity Type | Organization
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Legal Business Name | WHITE LOTUS ACUPUNCTURE
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 2620 FOUNTAIN VIEW DR SUITE 308
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City | HOUSTON
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State | TX
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Zip | 77057-7621
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Country | US
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Telephone | 713-706-3161
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 FOUNTAIN VIEW DR SUITE 308
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City | HOUSTON
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State | TX
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Zip | 77057-7621
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Country | US
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Telephone | 713-706-3161
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Fax |
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Authorized Official
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Title or Position | PRES/CEO
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Name | MS. DONNA S GUTHERY
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Credential | LAC
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Telephone | 713-706-3161
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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 | AC00637
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License Number State | TX
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