Provider Demographics
NPI:1013632389
Name:HOLISTIC CARE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:HOLISTIC CARE MEDICAL GROUP, LLC
Other - Org Name:HEALWELL ACUPUNCTURE AND HERBAL MEDICINE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:512-661-1919
Mailing Address - Street 1:9604 WOODVALE DR APT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-3562
Mailing Address - Country:US
Mailing Address - Phone:512-661-1919
Mailing Address - Fax:
Practice Address - Street 1:13625 POND SPRINGS RD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4400
Practice Address - Country:US
Practice Address - Phone:737-781-3845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-07
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty