Basic Information
| Provider Information | |||||||||
| NPI: | 1699032250 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DAO | ||||||||
| FirstName: | DOAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2902 STATE ST APT 21 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752042756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134198911 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5201 HARRY HINES BLVD | ||||||||
| Address2: | GRADUATE MEDICAL EDUCATION | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752357708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145908058 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2012 | ||||||||
| LastUpdateDate: | 04/19/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.