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General NPI Number Information
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NPI Number | 1811267362
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Entity Type | Organization
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Legal Business Name | ILSAN ACUPUNCTURE & HERBS P.C
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Dates
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Enumeration Date | 12/30/2011
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Last Update Date | 02/06/2013
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Provider Practice Location Address
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Address Line | 1220 BLALOCK RD SUITE 155
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City | HOUSTON
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State | TX
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Zip | 77055-6472
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Country | US
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Telephone | 713-461-1888
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Fax | 713-461-1888
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Provider Business Mailing Address
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Address Line | 1220 BLALOCK RD SUITE 155
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City | HOUSTON
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State | TX
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Zip | 77055-6472
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Country | US
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Telephone | 713-461-1888
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Fax | 713-461-1888
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAISUK BYUN
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Credential |
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Telephone | 713-461-1888
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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 | AC00743
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License Number State | TX
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