Healthcare Provider Details

I. General information

NPI: 1114888401
Provider Name (Legal Business Name): JULIANNA-NGOC KIM CAO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 FOURNACE PL
BELLAIRE TX
77401-2324
US

IV. Provider business mailing address

1 BAYLOR PLZ
HOUSTON TX
77030-3411
US

V. Phone/Fax

Practice location:
  • Phone: 713-634-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number123026
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: