Provider Demographics
NPI:1700326352
Name:BPSS ONE LLC
Entity Type:Organization
Organization Name:BPSS ONE LLC
Other - Org Name:SERASANA AUSTIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-385-6455
Mailing Address - Street 1:3801 N CAPITAL OF TEXAS HWY STE E120
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1479
Mailing Address - Country:US
Mailing Address - Phone:830-385-6455
Mailing Address - Fax:
Practice Address - Street 1:3801 N CAPITAL OF TEXAS HWY STE E120
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-1479
Practice Address - Country:US
Practice Address - Phone:830-385-6455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX AC0340171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty