NPIMap

Organization Active NPI

Evergreen Acupuncture

  • Acupuncturist
  • Austin, TX
National Provider Identifier
1144526658
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC01203 Issued in TX
Legal business name
EVERGREEN ACUPUNCTURE
Practice address
3004 Medical Arts St
Austin, TX 78705-3305
Phone
(512) 300-4047
NPI assigned
Jan 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Authorized official

Name
Connie Quezada, L.AC.
Title
Owner
Phone
(512) 300-4047

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC01203 TX Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MT038682 TX

Addresses

Primary practice location

3004 Medical Arts St
Austin, TX 78705-3305

Mailing address

1710 Shelbourne Dr
Austin, TX 78752-2148
Phone (512) 300-4047

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296432000000",
    "number": "1144526658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 SHELBOURNE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787522148",
            "telephone_number": "512-300-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 MEDICAL ARTS ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787053305",
            "telephone_number": "512-300-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ACUPUNCTURE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-31",
        "last_updated": "2011-01-31",
        "status": "A",
        "authorized_official_last_name": "QUEZADA",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-300-4047",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01203",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT038682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2011; 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.