Provider Demographics
NPI:1851533707
Name:EASTEN SPIRIT ACUPUNCTURE AND HERBAL CLINIC
Entity Type:Organization
Organization Name:EASTEN SPIRIT ACUPUNCTURE AND HERBAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SY-PING
Authorized Official - Middle Name:MIMI
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:832-549-3152
Mailing Address - Street 1:5218 CEDAR ST
Mailing Address - Street 2:STE. A
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4052
Mailing Address - Country:US
Mailing Address - Phone:832-549-3152
Mailing Address - Fax:
Practice Address - Street 1:5218 CEDAR ST
Practice Address - Street 2:STE. A
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4052
Practice Address - Country:US
Practice Address - Phone:832-549-3152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00596171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1043452907OtherNPI, TYPE 1