MEDICARE: FARWEST WELLNESS 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	173C00000X	Reflexologist
2	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1588260715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FARWEST WELLNESS LLC

Provider Business Mailing Address
First Line	:	10350 BANDERA RD STE 114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5616
Country	:	US
Telephone Number	:	210-530-1884
Fax Number	:	210-530-1224

Provider Business Practice Location Address
First Line	:	10350 BANDERA RD # SET114
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78250-5615
Country	:	US
Telephone Number	:	210-530-1884
Fax Number	:	210-530-1224

Authorized Official
Title or Position	:	MANAGER
Name	:	LINYING TAN
Credential	:	DR. LINYING TAN
Telephone Number	:	512-905-5948

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	08/28/2023

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Directions to “FARWEST WELLNESS LLC ” Practice Location

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