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General NPI Number Information
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NPI Number | 1700326352
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Entity Type | Organization
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Legal Business Name | BPSS ONE LLC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 3801 N CAPITAL OF TEXAS HWY STE E120
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City | AUSTIN
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State | TX
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Zip | 78746-1479
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Country | US
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Telephone | 830-385-6455
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Fax |
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Provider Business Mailing Address
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Address Line | 3801 N CAPITAL OF TEXAS HWY STE E120
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City | AUSTIN
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State | TX
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Zip | 78746-1479
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Country | US
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Telephone | 830-385-6455
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. PATTI MCCORMICK
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Credential |
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Telephone | 830-385-6455
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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 | TX AC0340
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License Number State | TX
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