Provider Demographics
NPI:1578650560
Name:LIN, PAUL CHINGKANG (LIC AC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:CHINGKANG
Last Name:LIN
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:C
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LIC AC
Mailing Address - Street 1:5404 RAIN CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6234
Mailing Address - Country:US
Mailing Address - Phone:512-707-8898
Mailing Address - Fax:512-707-8866
Practice Address - Street 1:4005 MANCHACA RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6737
Practice Address - Country:US
Practice Address - Phone:512-707-8898
Practice Address - Fax:512-707-8866
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00006171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist