Healthcare Provider Details

I. General information

NPI: 1881875383
Provider Name (Legal Business Name): TU ANH DAO D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 N LOCUST ST STE 102
DENTON TX
76201-4197
US

IV. Provider business mailing address

102 N LOCUST ST STE 102
DENTON TX
76201-4197
US

V. Phone/Fax

Practice location:
  • Phone: 940-382-8801
  • Fax: 940-382-8805
Mailing address:
  • Phone: 940-382-8801
  • Fax: 940-382-8805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1846
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: