Provider Demographics
NPI:1649460742
Name:BARSAM CUMMINGS, JULIE R (LIC AC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:BARSAM CUMMINGS
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8802 FEATHER HILL RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-1215
Mailing Address - Country:US
Mailing Address - Phone:512-492-5464
Mailing Address - Fax:
Practice Address - Street 1:8802 FEATHER HILL RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-1215
Practice Address - Country:US
Practice Address - Phone:512-492-5464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA219375171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist