=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750247631
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OUROBOROS ACUPUNCTURE AND ALCHEMY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 904 WEST AVE STE 109
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78701-2204
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-212-9593
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8705 MERIDIAN OAK LN
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78744-7971
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-212-9593
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DANIELLE BOWER
-----------------------------------------------------
Credential | LAC
-----------------------------------------------------
Telephone | 985-212-9593
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------