MEDICARE: HERBAN AUSTIN, LLC

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	#AC01694	TX

General Provider Information

NPI Number	:	1477097764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERBAN AUSTIN, LLC

Provider Business Mailing Address
First Line	:	1109 ALTUM ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78721-3034
Country	:	US
Telephone Number	:	512-900-5969
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 W PECAN ST
Second Line	:	SUITE #201
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-3669
Country	:	US
Telephone Number	:	512-900-5969
Fax Number	:

Authorized Official
Title or Position	:	CHIEF PRACTITIONER
Name	:	DR. NICOLE EILEEN FINKELSTEIN I
Credential	:	L.AC., DOM, RH(AHG)
Telephone Number	:	330-979-9403

Provider Enumeration Date	:	12/06/2016
Last Update Date	:	12/06/2016

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