Provider Demographics
NPI:1992263503
Name:BALANAY-TAHKINE, DANIEL KEKOA (L AC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KEKOA
Last Name:BALANAY-TAHKINE
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 MENCHACA RD STE 705
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-5378
Mailing Address - Country:US
Mailing Address - Phone:512-652-5884
Mailing Address - Fax:
Practice Address - Street 1:8700 MENCHACA RD STE 705
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5378
Practice Address - Country:US
Practice Address - Phone:512-652-5884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-04
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01898171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist