Fangyuan TCM LLC

Primary specialty

AcupuncturistTaxonomy code 171100000X

Legal business name

FANGYUAN TCM LLC

Practice address

1320 W Walnut Hill LN
Irving, TX 75038-3007

Phone

(972) 444-0660

Fax

(469) 262-5771

NPI assigned

Oct 28, 2020

Organization subpart

No

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

Authorized official

Name

Manuella Castellanos

Title

Director of Operations

Phone

(469) 426-8683

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1043810112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 W WALNUT HILL LN",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383007",
            "telephone_number": "972-444-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W WALNUT HILL LN",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383007",
            "telephone_number": "972-444-0660",
            "fax_number": "469-262-5771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANGYUAN TCM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "CASTELLANOS",
        "authorized_official_first_name": "MANUELLA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "469-426-8683"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in Irving, TX
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• Acupuncturist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.