Provider Demographics
NPI:1154649572
Name:LIFECARE ACUPUNCTURE & ALTERNATIVE MEDICINE CENTER,PLLC
Entity Type:Organization
Organization Name:LIFECARE ACUPUNCTURE & ALTERNATIVE MEDICINE CENTER,PLLC
Other - Org Name:DR. HENRY LI ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAOCHUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:OMD,PHD, LAC
Authorized Official - Phone:817-788-8388
Mailing Address - Street 1:4603 COLLEYVILLE BLVD, #120
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034
Mailing Address - Country:US
Mailing Address - Phone:817-788-8388
Mailing Address - Fax:817-788-8088
Practice Address - Street 1:4603 COLLEYVILLE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-3974
Practice Address - Country:US
Practice Address - Phone:817-788-8388
Practice Address - Fax:817-788-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC1029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAC 1029OtherACUPUNCTURIST