Provider Demographics
NPI:1831731884
Name:SUNG, CHENGYI (LAC)
Entity type:Individual
Prefix:
First Name:CHENGYI
Middle Name:
Last Name:SUNG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704 CASTLEMAN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78725-1720
Mailing Address - Country:US
Mailing Address - Phone:737-346-5136
Mailing Address - Fax:
Practice Address - Street 1:701 FM 685 STE 120
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2899
Practice Address - Country:US
Practice Address - Phone:737-300-7176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01931171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist