Provider Demographics
NPI:1760208292
Name:MA, LO CHUAN (LAC)
Entity type:Individual
Prefix:
First Name:LO CHUAN
Middle Name:
Last Name:MA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13740 N HIGHWAY 183 STE E4
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1821
Mailing Address - Country:US
Mailing Address - Phone:512-937-3999
Mailing Address - Fax:
Practice Address - Street 1:4861 WILLIAMS DR STE 111
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78633-2425
Practice Address - Country:US
Practice Address - Phone:512-277-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-30
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC02192171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist