Healthcare Provider Details

I. General information

NPI: 1982597811
Provider Name (Legal Business Name): JING CAO PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 MEDICAL DISTRICT DR
DALLAS TX
75235-7701
US

IV. Provider business mailing address

6465 ALDRIDGE DR
FRISCO TX
75035-7200
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-6686
  • Fax:
Mailing address:
  • Phone: 612-226-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number1169
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: