Individual provider Active NPI

Cynthia P. Ellison, LAC

  • Acupuncturist
  • Katy, TX
National Provider Identifier
1376770578
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC1049 Issued in TX
Practice address
21324 Provincial Blvd
Suite B
Katy, TX 77450-7580
Phone
(281) 685-3240
NPI assigned
Jun 15, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC1049 TX Primary

Addresses

Primary practice location

21324 Provincial Blvd
Suite B
Katy, TX 77450-7580

Mailing address

1562 Hoveden Dr
Katy, TX 77450-4904
Phone (281) 685-3240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC1049TXMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1376770578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 HOVEDEN DR",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774504904",
            "telephone_number": "281-685-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21324 PROVINCIAL BLVD",
            "address_2": "SUITE B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-685-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "CYNTHIA",
        "middle_name": "P.",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-15",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC1049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; 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.