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General NPI Number Information
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NPI Number | 1851533707
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Entity Type | Organization
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Legal Business Name | EASTEN SPIRIT ACUPUNCTURE AND HERBAL CLINIC
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Dates
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Enumeration Date | 03/24/2009
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Last Update Date | 03/24/2009
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Provider Practice Location Address
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Address Line | 5218 CEDAR ST STE. A
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City | BELLAIRE
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State | TX
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Zip | 77401-4052
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Country | US
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Telephone | 832-549-3152
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Fax |
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Provider Business Mailing Address
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Address Line | 5218 CEDAR ST STE. A
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City | BELLAIRE
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State | TX
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Zip | 77401-4052
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Country | US
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Telephone | 832-549-3152
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SY-PING MIMI FANG
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Credential | LAC
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Telephone | 832-549-3152
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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 | AC00596
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License Number State | TX
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