Provider Demographics
NPI:1902104847
Name:AC ROYAL MEDICAL GROUP
Entity Type:Organization
Organization Name:AC ROYAL MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/HERBALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:512-680-3802
Mailing Address - Street 1:3201 BEE CAVE RD
Mailing Address - Street 2:SUITE 154
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6771
Mailing Address - Country:US
Mailing Address - Phone:512-330-1772
Mailing Address - Fax:512-330-9085
Practice Address - Street 1:3201 BEE CAVE RD
Practice Address - Street 2:SUITE 154
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6771
Practice Address - Country:US
Practice Address - Phone:512-330-1772
Practice Address - Fax:512-330-9085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01197171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty