Provider Demographics
NPI:1144688136
Name:COMMUNITY ACUPUNCTURE & HERBS, LLC
Entity type:Organization
Organization Name:COMMUNITY ACUPUNCTURE & HERBS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:QUINCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:830-257-0357
Mailing Address - Street 1:327 EARL GARRETT ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-4514
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:327 EARL GARRETT ST
Practice Address - Street 2:SUITE 112
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4514
Practice Address - Country:US
Practice Address - Phone:830-257-0357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01259171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty