Basic Information
| Provider Information | |||||||||
| NPI: | 1992987283 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAO | ||||||||
| FirstName: | WEIWEI | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D., PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6210 E HIGHWAY 290 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787231142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124839569 | ||||||||
| FaxNumber: | 5124066216 | ||||||||
| Practice Location | |||||||||
| Address1: | 1401 MEDICAL PKWY STE 211 | ||||||||
| Address2: | |||||||||
| City: | CEDAR PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786135013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122601581 | ||||||||
| FaxNumber: | 5124067309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/29/2007 | ||||||||
| LastUpdateDate: | 06/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A110717 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | Q0614 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 339995802 | 05 | TX | MEDICAID | 339995803 | 05 | TX | MEDICAID |