Provider Demographics
NPI:1356574446
Name:BYUN, DAISUK (LICAC)
Entity type:Individual
Prefix:
First Name:DAISUK
Middle Name:
Last Name:BYUN
Suffix:
Gender:M
Credentials:LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 BLALOCK RD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6472
Mailing Address - Country:US
Mailing Address - Phone:713-461-1888
Mailing Address - Fax:713-461-1888
Practice Address - Street 1:1220 BLALOCK RD
Practice Address - Street 2:SUITE 155
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6472
Practice Address - Country:US
Practice Address - Phone:713-461-1888
Practice Address - Fax:713-461-1888
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00743171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist