MEDICARE: CHUNYAO TAO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	08-221	TX

General Provider Information

NPI Number	:	1053557090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHUNYAO TAO

Provider Business Mailing Address
First Line	:	7500 BEECHNUT ST
Second Line	:	STE 225
City	:	HOUSTON
State	:	TX
Zip	:	77074-4336
Country	:	US
Telephone Number	:	713-773-1115
Fax Number	:	713-773-1056

Provider Business Practice Location Address
First Line	:	7500 BEECHNUT ST
Second Line	:	STE 225
City	:	HOUSTON
State	:	TX
Zip	:	77074-4336
Country	:	US
Telephone Number	:	713-773-1115
Fax Number	:	713-773-1056

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2008
Last Update Date	:	01/08/2009

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Directions to “ CHUNYAO TAO ” Practice Location

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