Provider Demographics
NPI:1518418094
Name:GIANGARRA, KATRINA (LAC DIPL OM)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:GIANGARRA
Suffix:
Gender:F
Credentials:LAC DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11719 BEE CAVES RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6347
Mailing Address - Country:US
Mailing Address - Phone:512-263-4099
Mailing Address - Fax:512-263-4065
Practice Address - Street 1:11719 BEE CAVES RD
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-6347
Practice Address - Country:US
Practice Address - Phone:512-263-4099
Practice Address - Fax:512-263-4065
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist