Provider Demographics
NPI:1598013732
Name:SOBECK, CHARLOTTE (LAC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:SOBECK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5507 JOE SAYERS AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1309
Mailing Address - Country:US
Mailing Address - Phone:512-632-7674
Mailing Address - Fax:
Practice Address - Street 1:3921 STECK AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8709
Practice Address - Country:US
Practice Address - Phone:512-632-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00612171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist