Jose Pena, LAC, MAOM, DACM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC02049 Issued in TX

Practice address

2251 Double Creek Dr Ste 304
Round Rock, TX 78664-3831

Phone

(512) 246-0220

NPI assigned

Aug 11, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1033847686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 DOUBLE CREEK DR STE 304",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643831",
            "telephone_number": "512-246-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 DOUBLE CREEK DR STE 304",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643831",
            "telephone_number": "512-246-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "JOSE",
        "credential": "LAC, MAOM, DACM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC02049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Roseanne Pellegrino, M.P.A.C., P.A.-C
• Jennifer Peloquin, LMFT
• Angela Michelle Pena, APRN, FNP-BC
• Brianna Pena
• Evelyn Cristel Pena
• Gregory R Pendergast, LAT, ATC
• Solomon Pendleton, MD
• Lexy Penedo, LMT
• Yamini Penikalapati, DO
• Mouna Penmetsa, MD

• Acupuncturist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Acupuncturist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.