Provider Demographics
NPI:1952692121
Name:ACUPUNCTURE & CHINESE MEDICINE CLINIC, PLLC
Entity type:Organization
Organization Name:ACUPUNCTURE & CHINESE MEDICINE CLINIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST AND HERBALIS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHUANGZHU
Authorized Official - Middle Name:
Authorized Official - Last Name:QIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:512-921-7699
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD STE C2
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8658
Mailing Address - Country:US
Mailing Address - Phone:512-921-7699
Mailing Address - Fax:
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE C2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8658
Practice Address - Country:US
Practice Address - Phone:512-921-7699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00839171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty