MEDICARE: VIMALA V KUMAR L.AC

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

General Provider Information

NPI Number	:	1700015385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIMALA V KUMAR L.AC

Provider Business Mailing Address
First Line	:	3000 JOE DIMAGGIO BLVD STE 10
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3989
Country	:	US
Telephone Number	:	737-355-0004
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 JOE DIMAGGIO BLVD STE 10
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78665-3989
Country	:	US
Telephone Number	:	737-355-0004
Fax Number	:

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

Provider Enumeration Date	:	07/05/2009
Last Update Date	:	01/16/2026

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