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General NPI Number Information
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NPI Number | 1386947661
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Entity Type | Organization
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Legal Business Name | CHINESE ACUPUNCTURE CLINIC, LLC
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 12/23/2016
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Provider Practice Location Address
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Address Line | 3613 WILLIAMS DR SUITE 303
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City | GEORGETOWN
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State | TX
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Zip | 78628-1377
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Country | US
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Telephone | 512-864-1441
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Fax | 800-479-8616
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Provider Business Mailing Address
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Address Line | 3613 WILLIAMS DR SUITE 303
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City | GEORGETOWN
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State | TX
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Zip | 78628-1377
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Country | US
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Telephone | 512-864-1441
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Fax | 800-479-8616
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Authorized Official
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Title or Position | OWNER
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Name | MRS. HEDY I CHEN
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Credential | L. AC.
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Telephone | 512-864-1441
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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 | TXAC1215
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License Number State | TX
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