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General NPI Number Information
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NPI Number | 1639429467
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Entity Type | Organization
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Legal Business Name | HIGHLAND LAKES ACUPUNCTURE, PLLC
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 09/19/2012
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Provider Practice Location Address
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Address Line | 3821 JUNIPER TRCE SUITE 107
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City | AUSTIN
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State | TX
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Zip | 78738-5506
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Country | US
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Telephone | 512-215-9847
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Fax |
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Provider Business Mailing Address
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Address Line | 3821 JUNIPER TRCE SUITE 107
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City | AUSTIN
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State | TX
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Zip | 78738-5506
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Country | US
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Telephone | 512-215-9847
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Fax |
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Authorized Official
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Title or Position | CO-OWNER, ACUPUNCTURIST
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Name | ELIZABETH HARDWICK
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Credential | LAC
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Telephone | 512-215-9847
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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 | AC01295
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License Number State | TX
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