Provider Demographics
NPI:1437376217
Name:YANG, GUANG BO (L,AC)
Entity Type:Individual
Prefix:
First Name:GUANG
Middle Name:BO
Last Name:YANG
Suffix:
Gender:M
Credentials:L,AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20815 DEAUVILLE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4150
Mailing Address - Country:US
Mailing Address - Phone:281-528-6276
Mailing Address - Fax:281-895-7676
Practice Address - Street 1:13303 CHAMPION FOREST DR STE 10
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2650
Practice Address - Country:US
Practice Address - Phone:281-583-5898
Practice Address - Fax:281-895-7676
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAC00218171100000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered175L00000XOther Service ProvidersHomeopath