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Individual

IVAN D. MATULA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC., O.M.D.,

Contact information

Practice address
711 W 38TH ST, SUITE G3, AUSTIN, TX 78705-1121
(512) 517-9830
(512) 517-9830
Mailing address
711 W 38TH ST, SUITE G3, AUSTIN, TX 78705-1121
(512) 517-9830
(512) 517-9830

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
291
NM
171100000X
Acupuncturist
Primary
AC00034
TX

Other

Enumeration date
05/25/2007
Last updated
07/08/2007
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