Healthcare Provider Details

I. General information

NPI: 1164110490
Provider Name (Legal Business Name): BAO HUY DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6431 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

10614 RED SPRUCE LN
HOUSTON TX
77040-7100
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-4472
  • Fax:
Mailing address:
  • Phone: 281-650-5785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2023
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2023
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: