Provider Demographics
NPI:1972724730
Name:XU, QIAO (DO)
Entity type:Individual
Prefix:MS
First Name:QIAO
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11236 SOUTH BAY LANE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739
Mailing Address - Country:US
Mailing Address - Phone:512-301-0786
Mailing Address - Fax:512-301-0786
Practice Address - Street 1:11236 SOUTH BAY LANE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78739
Practice Address - Country:US
Practice Address - Phone:512-301-0786
Practice Address - Fax:512-301-0786
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00360171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist