Healthcare Provider Details

I. General information

NPI: 1407029689
Provider Name (Legal Business Name): TIMOTHY DUY DAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 W 15TH ST BLDG B, SUITE 320
PLANO TX
75075-4737
US

IV. Provider business mailing address

3801 W 15TH ST STE 320
PLANO TX
75075-7767
US

V. Phone/Fax

Practice location:
  • Phone: 972-985-8838
  • Fax: 844-292-1457
Mailing address:
  • Phone: 972-985-8838
  • Fax: 844-292-1457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberP3874
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberP3874
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: