Provider Demographics
NPI:1164063392
Name:BU, XIAOJUN
Entity Type:Individual
Prefix:
First Name:XIAOJUN
Middle Name:
Last Name:BU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10020 GERTRUDIS LOOP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-2782
Mailing Address - Country:US
Mailing Address - Phone:832-827-3943
Mailing Address - Fax:
Practice Address - Street 1:13740 N US HIGHWAY 183 STE E4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1821
Practice Address - Country:US
Practice Address - Phone:512-937-3999
Practice Address - Fax:512-233-0068
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-29
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01874171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty