Healthcare Provider Details

I. General information

NPI: 1033388764
Provider Name (Legal Business Name): ROBERT C. MAO, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 02/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16651 SOUTHWEST FWY STE 180
SUGAR LAND TX
77479-2346
US

IV. Provider business mailing address

16651 SOUTHWEST FWY STE 180
SUGAR LAND TX
77479-2346
US

V. Phone/Fax

Practice location:
  • Phone: 281-265-8800
  • Fax:
Mailing address:
  • Phone: 281-265-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberF9772
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberF9772
License Number StateTX

VIII. Authorized Official

Name: ROBERT MAO
Title or Position: OWNER
Credential: M.D.
Phone: 281-265-8800