Healthcare Provider Details

I. General information

NPI: 1982702031
Provider Name (Legal Business Name): KHOA T CAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11034 SCARSDALE BLVD SUITE B
HOUSTON TX
77089-6068
US

IV. Provider business mailing address

11034 SCARSDALE BLVD SUITE B
HOUSTON TX
77089-6068
US

V. Phone/Fax

Practice location:
  • Phone: 281-484-0449
  • Fax: 281-484-7210
Mailing address:
  • Phone: 281-484-0449
  • Fax: 281-484-7210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberK7428
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberK7428
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: