MEDICARE: SHERI MOODY L.AC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist
2	171100000X	Acupuncturist	AC01257	TX

General Provider Information

NPI Number	:	1053607846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERI MOODY L.AC.

Provider Business Mailing Address
First Line	:	PO BOX 91646
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78709-1646
Country	:	US
Telephone Number	:	512-699-5362
Fax Number	:

Provider Business Practice Location Address
First Line	:	2007 BERT AVE
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-7527
Country	:	US
Telephone Number	:	512-699-5362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	01/27/2020

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Directions to “ SHERI MOODY L.AC.” Practice Location

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