Provider Demographics
NPI:1730402587
Name:SIU, YEN KAM (LAC)
Entity type:Individual
Prefix:MR
First Name:YEN
Middle Name:KAM
Last Name:SIU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 BURNET RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-2244
Mailing Address - Country:US
Mailing Address - Phone:512-450-1595
Mailing Address - Fax:
Practice Address - Street 1:7423 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-2244
Practice Address - Country:US
Practice Address - Phone:512-450-1595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01109171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist