# TAO BLOSSOM PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** TAO BLOSSOM
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174020853
- **Authorized official:** DEVON GRAY M.AC., DIPL.OM, L.AC (OWNER, LICENSED ACUPUNCTURIST)
- **Authorized official phone:** (512) 577-9802

## Contact information

- **Practice address:** 1001 S CAPITAL OF TEXAS HWY STE 210, WEST LAKE HILLS, TX 78746-6450
- **Practice address phone:** (804) 363-7559
- **Mailing address:** 1001 S CAPITAL OF TEXAS HWY STE 210, WEST LAKE HILLS, TX 78746-6450
- **Mailing address phone:** (804) 363-7559

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC01800 | TX | Yes |

## Other

- **Enumeration date:** 04/10/2018
- **Last updated:** 04/10/2018