Provider Demographics
NPI:1639357221
Name:ZHANG, BUSH BAO-XING (LAC)
Entity Type:Individual
Prefix:MR
First Name:BUSH
Middle Name:BAO-XING
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10851 FERGUSON RD
Mailing Address - Street 2:#A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-2615
Mailing Address - Country:US
Mailing Address - Phone:972-279-4888
Mailing Address - Fax:214-321-3459
Practice Address - Street 1:10851 FERGUSON RD
Practice Address - Street 2:#A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-2615
Practice Address - Country:US
Practice Address - Phone:972-279-4888
Practice Address - Fax:214-321-3459
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC000188171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist