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General NPI Number Information
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NPI Number | 1972773877
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE CHANGES LIVES
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 3004 MEDICAL ARTS ST
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City | AUSTIN
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State | TX
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Zip | 78705-3305
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Country | US
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Telephone | 512-825-3305
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Fax | 512-524-1002
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Provider Business Mailing Address
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Address Line | 3004 MEDICAL ARTS ST
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City | AUSTIN
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State | TX
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Zip | 78705-3305
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Country | US
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Telephone | 512-825-3305
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Fax | 512-524-1002
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Authorized Official
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Title or Position | TEXAS LICENSED ACUPUNCTURIST, OWNER
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Name | WILLIAM JOSEPH ZACHARY
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Credential | L.AC.
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Telephone | 512-825-3305
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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 | AC00757
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License Number State | TX
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