1528032885 NPI number — SOUTHWEST ACUPUNCTURE CLINIC, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528032885 NPI number — SOUTHWEST ACUPUNCTURE CLINIC, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST ACUPUNCTURE CLINIC, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528032885
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 S GREENVILLE AVE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
RICHARDSON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75081-5090
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-669-1346
Provider Business Mailing Address Fax Number:
972-669-1669

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 S GREENVILLE AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
RICHARDSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75081-5090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-669-1346
Provider Business Practice Location Address Fax Number:
972-669-1669
Provider Enumeration Date:
02/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HU
Authorized Official First Name:
SHAIN
Authorized Official Middle Name:
JAN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
972-669-1346

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC 00003 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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