Provider Demographics
NPI:1841474483
Name:WARD, SHUKO Y (LAC)
Entity type:Individual
Prefix:MS
First Name:SHUKO
Middle Name:Y
Last Name:WARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 CEDAR POST LN APT 7
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4340
Mailing Address - Country:US
Mailing Address - Phone:713-502-3646
Mailing Address - Fax:
Practice Address - Street 1:1300 S FRAZIER ST
Practice Address - Street 2:SUITE 107
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-4400
Practice Address - Country:US
Practice Address - Phone:936-539-4114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00815171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist