Healthcare Provider Details

I. General information

NPI: 1205838588
Provider Name (Legal Business Name): MICHAEL V DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 DESCO LN
GRAND PRAIRIE TX
75051-1685
US

IV. Provider business mailing address

845 DESCO LN
GRAND PRAIRIE TX
75051-1685
US

V. Phone/Fax

Practice location:
  • Phone: 817-465-4141
  • Fax: 855-862-9350
Mailing address:
  • Phone: 817-465-4141
  • Fax: 855-862-9350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberJ7772
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: