Provider Demographics
NPI:1407603640
Name:CARLSON, ALICE (ACUPUNCTURE)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:ACUPUNCTURE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421645
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1645
Mailing Address - Country:US
Mailing Address - Phone:832-867-1787
Mailing Address - Fax:
Practice Address - Street 1:5011 N SHEPHERD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-1624
Practice Address - Country:US
Practice Address - Phone:832-867-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist