MEDICARE: PADDY TAWADA LAC

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	AC00361	TX

General Provider Information

NPI Number	:	1114145851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PADDY TAWADA LAC

Provider Business Mailing Address
First Line	:	1601 E 5TH ST
Second Line	:	SUITE 105
City	:	AUSTIN
State	:	TX
Zip	:	78702-4469
Country	:	US
Telephone Number	:	512-478-4732
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 E 5TH ST
Second Line	:	SUITE 105
City	:	AUSTIN
State	:	TX
Zip	:	78702-4469
Country	:	US
Telephone Number	:	512-478-4732
Fax Number	:

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

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	07/08/2007

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Directions to “ PADDY TAWADA LAC” Practice Location

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