Provider Demographics
NPI:1568070977
Name:BL INTEGRATIVE HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:BL INTEGRATIVE HEALTHCARE, PLLC
Other - Org Name:TEXAS ACUPUNCTURE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:512-761-7796
Mailing Address - Street 1:13150 SENLAC DR STE 170
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-1241
Mailing Address - Country:US
Mailing Address - Phone:469-930-1166
Mailing Address - Fax:
Practice Address - Street 1:13150 SENLAC DR STE 170
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-1241
Practice Address - Country:US
Practice Address - Phone:469-930-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty