=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851840581
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ZOI CLINIC, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2016
-----------------------------------------------------
Last Update Date | 09/22/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 N MAIN ST SUITE 100
-----------------------------------------------------
City | BUDA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78610-3314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-648-0610
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 320 N MAIN ST SUITE 100
-----------------------------------------------------
City | BUDA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78610-3314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-648-0610
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED ACUPUNCTURIST / HERBALIST
-----------------------------------------------------
Name | BRITTANY LYNNE DAVIS
-----------------------------------------------------
Credential | L.AC.
-----------------------------------------------------
Telephone | 512-648-0610
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC01613
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------