MEDICARE: ANDRA H MILLIAN 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	AC00522	TX

General Provider Information

NPI Number	:	1659536472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRA H MILLIAN LAC

Provider Business Mailing Address
First Line	:	7409 VOL WALKER DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-2166
Country	:	US
Telephone Number	:	512-892-0288
Fax Number	:

Provider Business Practice Location Address
First Line	:	3316 BEE CAVE RD STE B
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6690
Country	:	US
Telephone Number	:	512-892-0288
Fax Number	:	512-410-2322

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

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	03/07/2013

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