Provider Demographics
NPI:1093723124
Name:AU, WINNIE Y (LAC, DIPL AC)
Entity Type:Individual
Prefix:
First Name:WINNIE
Middle Name:Y
Last Name:AU
Suffix:
Gender:F
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:YAN
Other - Middle Name:FEN
Other - Last Name:HO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:209 BEDFORD RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6287
Mailing Address - Country:US
Mailing Address - Phone:817-590-8188
Mailing Address - Fax:817-590-8788
Practice Address - Street 1:209 BEDFORD RD
Practice Address - Street 2:SUITE 160
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6287
Practice Address - Country:US
Practice Address - Phone:817-590-8188
Practice Address - Fax:817-590-8788
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00630171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M8425OtherBCBS PROVIDER #