Provider Demographics
NPI:1811267362
Name:ILSAN ACUPUNCTURE & HERBS P.C
Entity type:Organization
Organization Name:ILSAN ACUPUNCTURE & HERBS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAISUK
Authorized Official - Middle Name:
Authorized Official - Last Name:BYUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-461-1888
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00743171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty