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General NPI Number Information
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NPI Number | 1497500060
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Entity Type | Organization
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Legal Business Name | MAGIC CHINESE MEDICINE LLC
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 18756 STONE OAK PKWY STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4354
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Country | US
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Telephone | 210-214-0729
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Fax | 210-664-7399
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Provider Business Mailing Address
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Address Line | 19002 GENTLE KNL
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3415
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Country | US
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Telephone | 210-214-0729
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | KE CHEN
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Credential | LAC
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Telephone | 121-021-4072
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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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