Provider Demographics
NPI:1700111630
Name:LI, HAOCHUAN (OMD,PHD, LAC)
Entity type:Individual
Prefix:DR
First Name:HAOCHUAN
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:OMD,PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-4120
Mailing Address - Country:US
Mailing Address - Phone:469-952-8238
Mailing Address - Fax:
Practice Address - Street 1:4603 COLLEYVILLE BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034
Practice Address - Country:US
Practice Address - Phone:469-952-8238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC1029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist