# FANGYUAN TCM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043810112
- **Authorized official:** MANUELLA CASTELLANOS (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (469) 426-8683

## Contact information

- **Practice address:** 1320 W WALNUT HILL LN, IRVING, TX 75038-3007
- **Practice address phone:** (972) 444-0660
- **Practice address fax:** (469) 262-5771
- **Mailing address:** 1320 W WALNUT HILL LN, IRVING, TX 75038-3007
- **Mailing address phone:** (972) 444-0660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 10/28/2020
- **Last updated:** 10/28/2020