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General NPI Number Information
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NPI Number | 1902104847
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Entity Type | Organization
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Legal Business Name | AC ROYAL MEDICAL GROUP
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 3201 BEE CAVE RD SUITE 154
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City | AUSTIN
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State | TX
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Zip | 78746-6771
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Country | US
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Telephone | 512-330-1772
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Fax | 512-330-9085
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Provider Business Mailing Address
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Address Line | 3201 BEE CAVE RD SUITE 154
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City | AUSTIN
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State | TX
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Zip | 78746-6771
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Country | US
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Telephone | 512-330-1772
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Fax | 512-330-9085
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Authorized Official
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Title or Position | ACUPUNCTURIST/HERBALIST
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Name | ASHLEY FARR
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Credential | L.AC.
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Telephone | 512-680-3802
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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 | AC01197
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License Number State | TX
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