Provider Demographics
NPI:1073615670
Name:LIU, KAIXUN (LAC, OMD)
Entity Type:Individual
Prefix:
First Name:KAIXUN
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:LAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13480 VETERANS MEMORIAL DR
Mailing Address - Street 2:SUITE E-1
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13480 VETERANS MEMORIAL DR
Practice Address - Street 2:SUITE E-1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1606
Practice Address - Country:US
Practice Address - Phone:281-537-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00044171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0021LROtherBCBS GROUP
TX0015LQOtherBCBS PROVIDER NUMBER
TX8M8432OtherBCBS PROVIDER NUMBER