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General NPI Number Information
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NPI Number | 1891191235
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Entity Type | Organization
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Legal Business Name | MARIPOSA FAMILY ACUPUNCTURE & WELLNESS, PLLC
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 3445 EXECUTIVE CENTER DR SUITE 229
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City | AUSTIN
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State | TX
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Zip | 78731-1680
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Country | US
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Telephone | 512-814-5570
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Fax |
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Provider Business Mailing Address
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Address Line | 3445 EXECUTIVE CENTER DR SUITE 229
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City | AUSTIN
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State | TX
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Zip | 78731-1680
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Country | US
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Telephone | 512-814-5570
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | TAMMY R GARCIA
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Credential | L.AC.
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Telephone | 512-814-5570
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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 | AC01386
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License Number State | TX
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