Provider Demographics
NPI:1275883910
Name:ACUPUNCTURE CENTER OF DALLAS INC
Entity Type:Organization
Organization Name:ACUPUNCTURE CENTER OF DALLAS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SUK-JOO
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:LICA
Authorized Official - Phone:214-691-3210
Mailing Address - Street 1:11661 PRESTON RD
Mailing Address - Street 2:#170
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-7012
Mailing Address - Country:US
Mailing Address - Phone:214-691-3210
Mailing Address - Fax:214-739-6262
Practice Address - Street 1:11661 PRESTON RD
Practice Address - Street 2:#170
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-7012
Practice Address - Country:US
Practice Address - Phone:214-691-3210
Practice Address - Fax:214-739-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00077171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty