Provider Demographics
NPI:1982286027
Name:LIU, KUN (L AC)
Entity Type:Individual
Prefix:
First Name:KUN
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12136 TUMBLING CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-2091
Mailing Address - Country:US
Mailing Address - Phone:626-227-5517
Mailing Address - Fax:
Practice Address - Street 1:2500 W WILLIAM CANNON DR STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5288
Practice Address - Country:US
Practice Address - Phone:626-227-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14312171100000X
TXAC01793171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty