Provider Demographics
NPI:1821284522
Name:XU, LI
Entity Type:Individual
Prefix:
First Name:LI
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GEORGIA ST. NE C-2
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-2572
Mailing Address - Country:US
Mailing Address - Phone:505-206-5676
Mailing Address - Fax:505-221-5157
Practice Address - Street 1:3901 GEORGIA ST. NE C-2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2572
Practice Address - Country:US
Practice Address - Phone:505-206-5676
Practice Address - Fax:505-221-5157
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist