Provider Demographics
NPI:1083702468
Name:HAN, QIUXIA (LAC)
Entity Type:Individual
Prefix:
First Name:QIUXIA
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 MANCHACA RD STE D
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4948
Mailing Address - Country:US
Mailing Address - Phone:512-217-3855
Mailing Address - Fax:512-462-0800
Practice Address - Street 1:6301 MANCHACA RD STE D
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4948
Practice Address - Country:US
Practice Address - Phone:512-217-3855
Practice Address - Fax:512-462-0800
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00715171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist