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General NPI Number Information
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NPI Number | 1568076834
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Entity Type | Individual
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Provider Name | LISA ALLEN LAC
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Gender | Female
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 4131 SPICEWOOD SPRINGS ROAD, ST O-2
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City | AUSTIN
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State | TX
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Zip | 78759-7875
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Country | US
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Telephone | 512-575-3248
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 JESTER BLVD
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City | AUSTIN
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State | TX
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Zip | 78750-7923
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Country | US
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Telephone | 650-743-3596
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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 | PENDING
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License Number State | TX
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