Provider Demographics
NPI:1063889079
Name:BENEFIT ACUPUNCTURE CENTER PLLC
Entity type:Organization
Organization Name:BENEFIT ACUPUNCTURE CENTER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, PHD
Authorized Official - Phone:817-520-5333
Mailing Address - Street 1:5200 COLLEYVILLE BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5828
Mailing Address - Country:US
Mailing Address - Phone:817-520-5333
Mailing Address - Fax:
Practice Address - Street 1:5200 COLLEYVILLE BLVD STE E
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5828
Practice Address - Country:US
Practice Address - Phone:817-520-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01255171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty