Provider Demographics
NPI:1245799949
Name:PLUNK, BRANDY N (LAC)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:N
Last Name:PLUNK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 YANDALL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2088
Mailing Address - Country:US
Mailing Address - Phone:512-797-9507
Mailing Address - Fax:
Practice Address - Street 1:2611 YANDALL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-2088
Practice Address - Country:US
Practice Address - Phone:512-797-9507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01871171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty