Provider Demographics
NPI:1306388509
Name:LARGEY, TIFFANY K (LAC)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:K
Last Name:LARGEY
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 1:3817 TAMIL ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2537
Mailing Address - Country:US
Mailing Address - Phone:512-826-3933
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL ARTS ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3305
Practice Address - Country:US
Practice Address - Phone:512-826-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-06
Last Update Date:2016-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01546171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist