Provider Demographics
NPI:1528551900
Name:COMAL SPRINGS COMMUNITY ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:COMAL SPRINGS COMMUNITY ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:NICOSIA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:830-822-6315
Mailing Address - Street 1:965 N WALNUT AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5442
Mailing Address - Country:US
Mailing Address - Phone:830-822-6315
Mailing Address - Fax:
Practice Address - Street 1:965 N WALNUT AVE STE 100
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5442
Practice Address - Country:US
Practice Address - Phone:830-822-6315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty