MEDICARE: TEMPLE ACUPUNCTURE & WELLNESS LTD LLP

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	AC01170	TX

General Provider Information

NPI Number	:	1417408824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE ACUPUNCTURE & WELLNESS LTD LLP

Provider Business Mailing Address
First Line	:	3602 WHITE OAK DR
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-3606
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5100 MIDWAY DR STE 102
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-1471
Country	:	US
Telephone Number	:	254-627-0439
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MADALINA MATEESCU
Credential	:
Telephone Number	:	254-627-0439

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	10/20/2016

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