Provider Demographics
NPI:1558890178
Name:YELLOW DRAGON ACUPUNCTURE, PLLC
Entity Type:Organization
Organization Name:YELLOW DRAGON ACUPUNCTURE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:830-358-1555
Mailing Address - Street 1:1067 FM 306 STE 107
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4684
Mailing Address - Country:US
Mailing Address - Phone:830-358-1555
Mailing Address - Fax:830-358-1556
Practice Address - Street 1:1067 FM 306 STE 107
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4684
Practice Address - Country:US
Practice Address - Phone:830-358-1555
Practice Address - Fax:830-358-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01764171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty