Provider Demographics
NPI:1487984555
Name:MA, TAO (OMD,LAC, PHD)
Entity type:Individual
Prefix:
First Name:TAO
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:OMD,LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 SOUTHWEST FWY STE 1210
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7344
Mailing Address - Country:US
Mailing Address - Phone:713-572-7540
Mailing Address - Fax:713-621-0881
Practice Address - Street 1:4126 SOUTHWEST FWY STE 1210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7344
Practice Address - Country:US
Practice Address - Phone:713-572-7540
Practice Address - Fax:713-621-0881
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00697171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist