Provider Demographics
NPI:1407018971
Name:YEN ACUPUNCTURE & HERBAL CLINIC, INC.
Entity Type:Organization
Organization Name:YEN ACUPUNCTURE & HERBAL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:I
Authorized Official - Last Name:YEN
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:512-260-1710
Mailing Address - Street 1:715 DISCOVERY BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2287
Mailing Address - Country:US
Mailing Address - Phone:512-260-1710
Mailing Address - Fax:
Practice Address - Street 1:715 DISCOVERY BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2287
Practice Address - Country:US
Practice Address - Phone:512-260-1710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC755171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8M8458OtherBLUE CROSS BLUE SHIELD PROVIDER NUMBER (JIMMY I YEN)
TX0075LQOtherBLUE CROSS BLUE SHIELD PROVIDER NUMBER (YEN ACUPUNCTURE & HERBAL CLINIC, INC.)