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General NPI Number Information
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NPI Number | 1487048831
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Entity Type | Organization
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Legal Business Name | TX ENTERPRISES
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 1784 E. OAKTON #106
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City | DES PLAINES
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State | IL
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Zip | 60018
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Country | US
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Telephone | 312-282-6461
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Fax |
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Provider Business Mailing Address
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Address Line | 1784 E. OAKTON #106
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City | DES PLAINES
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State | IL
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Zip | 60018
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Country | US
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Telephone | 312-282-6461
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAO SMITH
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Credential | ACUPUNCTURIST
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Telephone | 312-282-6461
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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 | 198.000586
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License Number State | IL
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