Provider Demographics
NPI:1760661557
Name:WANG, XIZI (MS IN TCM)
Entity Type:Individual
Prefix:
First Name:XIZI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:MS IN TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 KELLER PKWY
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-2302
Mailing Address - Country:US
Mailing Address - Phone:817-965-0999
Mailing Address - Fax:817-337-9109
Practice Address - Street 1:413 KELLER PKWY
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-2302
Practice Address - Country:US
Practice Address - Phone:817-965-0999
Practice Address - Fax:817-337-9109
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00909171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist