MEDICARE: DONG XUN ZHANG DAOM, PHD, LIC. 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	AC00158	TX

General Provider Information

NPI Number	:	1124458328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONG XUN ZHANG DAOM, PHD, LIC. AC.

Provider Business Mailing Address
First Line	:	3701 BEE CAVES RD
Second Line	:	SUITE # 102
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5385
Country	:	US
Telephone Number	:	512-608-1928
Fax Number	:	512-306-1721

Provider Business Practice Location Address
First Line	:	3701 BEE CAVES RD
Second Line	:	SUITE # 102
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5385
Country	:	US
Telephone Number	:	512-608-1928
Fax Number	:	512-306-1721

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

Provider Enumeration Date	:	11/25/2013
Last Update Date	:	11/25/2013

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