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General NPI Number Information
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NPI Number | 1427377795
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Entity Type | Individual
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Provider Name | PHYLLIS KUNG L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2010
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Last Update Date | 05/25/2010
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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 | 512-445-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 DICKSON DR 317
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City | AUSTIN
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State | TX
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Zip | 78704-3963
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Country | US
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Telephone | 512-650-8880
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TX
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