Provider Demographics
NPI:1558733345
Name:WELBRIDGE ACUPUNCTURE
Entity Type:Organization
Organization Name:WELBRIDGE ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:832-236-3389
Mailing Address - Street 1:2601 W LAKE HOUSTON PKWY
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5222
Mailing Address - Country:US
Mailing Address - Phone:832-236-3389
Mailing Address - Fax:
Practice Address - Street 1:2601 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5222
Practice Address - Country:US
Practice Address - Phone:832-236-3389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty