Provider Demographics
NPI:1295315075
Name:CHAE, BELLA
Entity type:Individual
Prefix:
First Name:BELLA
Middle Name:
Last Name:CHAE
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 1:1210 COTTONWOOD CREEK TRL.
Mailing Address - Street 2:SUITE #325
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-986-4289
Mailing Address - Fax:
Practice Address - Street 1:1210 COTTONWOOD TRL.
Practice Address - Street 2:SUITE #325
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7861
Practice Address - Country:US
Practice Address - Phone:512-547-7797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC02011171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist