Healthcare Provider Details

I. General information

NPI: 1235208430
Provider Name (Legal Business Name): HIEP A CAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3465 W WALNUT ST STE 211B
GARLAND TX
75042-7140
US

IV. Provider business mailing address

3465 W WALNUT ST STE 211B
GARLAND TX
75042-7140
US

V. Phone/Fax

Practice location:
  • Phone: 214-703-9788
  • Fax: 214-703-9799
Mailing address:
  • Phone: 214-794-9448
  • Fax: 580-256-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN8770
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: