# EVERGREEN ACUPUNCTURE

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

## Provider details

- **NPI number:** 1144526658
- **Authorized official:** CONNIE QUEZADA L.AC. (OWNER)
- **Authorized official phone:** (512) 300-4047

## Contact information

- **Practice address:** 3004 MEDICAL ARTS ST, AUSTIN, TX 78705-3305
- **Practice address phone:** (512) 300-4047
- **Mailing address:** 1710 SHELBOURNE DR, AUSTIN, TX 78752-2148
- **Mailing address phone:** (512) 300-4047

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC01203 | TX | Yes |
| 225700000X | Massage Therapist | MT038682 | TX | — |

## Other

- **Enumeration date:** 01/31/2011
- **Last updated:** 01/31/2011