Healthcare Provider Details

I. General information

NPI: 1124349055
Provider Name (Legal Business Name): TUAN DAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 S MAIN ST
LUMBERTON TX
77657-7390
US

IV. Provider business mailing address

1233 S MAIN ST
LUMBERTON TX
77657-7390
US

V. Phone/Fax

Practice location:
  • Phone: 409-227-4529
  • Fax:
Mailing address:
  • Phone: 409-227-4529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP8349
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: