Organization
GRACE & YOUNG ACUPUNCTURE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHENGYAN TAN (OWNER)
(512) 994-5854
Entity
Organization
Contact information
Practice address
12411 HYMEADOW DR STE 3D, AUSTIN, TX 78750-1829
(512) 609-8095
Mailing address
12411 HYMEADOW DR STE 3D, AUSTIN, TX 78750-1829
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAQH12475412
BLUE CROSS BLUE SHIELD, UNITEDHEALTHCARECAQH
TX
Enumeration date
03/22/2020
Last updated
04/18/2020
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