Healthcare Provider Details

I. General information

NPI: 1184134546
Provider Name (Legal Business Name): DR. DAVID DAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2017
Last Update Date: 10/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 FULTON ST
HOUSTON TX
77009-7835
US

IV. Provider business mailing address

711 N MODENA ST
ANAHEIM CA
92801-3234
US

V. Phone/Fax

Practice location:
  • Phone: 832-487-0040
  • Fax:
Mailing address:
  • Phone: 714-329-0755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number33562
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: