Healthcare Provider Details
I. General information
NPI: 1225902729
Provider Name (Legal Business Name): ALEXIS DAO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/30/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 ROAD TO SIX FLAGS W STE 146
ARLINGTON TX
76012-2600
US
IV. Provider business mailing address
447 N MAIN ST APT 2223
FORT WORTH TX
76164-9501
US
V. Phone/Fax
- Phone: 817-887-8182
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | PA19431 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: