MEDICARE: MISS RACHEL SARAH WEISBERG 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	14829	CA
2	171100000X	Acupuncturist	AC1402	TX

General Provider Information

NPI Number	:	1184986911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RACHEL SARAH WEISBERG LAC

Provider Business Mailing Address
First Line	:	2023 E 2ND ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-4565
Country	:	US
Telephone Number	:	415-816-9793
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 E 2ND ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-4565
Country	:	US
Telephone Number	:	415-816-9793
Fax Number	:

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

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	04/12/2013

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