Provider Demographics
NPI:1275783987
Name:UPPENA, MEGUMI (LAC)
Entity Type:Individual
Prefix:
First Name:MEGUMI
Middle Name:
Last Name:UPPENA
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 1:7216 SENECA FALLS LP
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-2215
Mailing Address - Country:US
Mailing Address - Phone:512-431-7997
Mailing Address - Fax:
Practice Address - Street 1:3006 BEE CAVES RD STE A290
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6789
Practice Address - Country:US
Practice Address - Phone:512-431-7997
Practice Address - Fax:512-329-6957
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist