Provider Demographics
NPI:1659023554
Name:HUNG, YA-WEN (LIC AC)
Entity Type:Individual
Prefix:
First Name:YA-WEN
Middle Name:
Last Name:HUNG
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:YA-WEN
Other - Middle Name:
Other - Last Name:HUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4005 MENCHACA RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6737
Mailing Address - Country:US
Mailing Address - Phone:210-509-8080
Mailing Address - Fax:210-509-8181
Practice Address - Street 1:9240 GUILBEAU RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-3089
Practice Address - Country:US
Practice Address - Phone:210-509-8080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist