Healthcare Provider Details

I. General information

NPI: 1770255374
Provider Name (Legal Business Name): BRYANT DAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2021
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4412 NORTH FWY
HOUSTON TX
77022-3606
US

IV. Provider business mailing address

17931 SUGARLOAF BAY DR
CYPRESS TX
77429-7623
US

V. Phone/Fax

Practice location:
  • Phone: 713-300-0511
  • Fax:
Mailing address:
  • Phone: 281-684-5398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number69417
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: