Healthcare Provider Details

I. General information

NPI: 1124281118
Provider Name (Legal Business Name): LONG BAO CAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 MAIN ST STE 105
RICHMOND TX
77469-3230
US

IV. Provider business mailing address

4911 SANDHILL DR
SUGAR LAND TX
77479-5320
US

V. Phone/Fax

Practice location:
  • Phone: 281-633-4925
  • Fax: 281-633-4929
Mailing address:
  • Phone: 281-238-7870
  • Fax: 281-633-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberN8495
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: