Provider Demographics
NPI:1033388764
Name:ROBERT C. MAO, M.D., P.A.
Entity Type:Organization
Organization Name:ROBERT C. MAO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-265-8800
Mailing Address - Street 1:16651 SOUTHWEST FWY STE 180
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2346
Mailing Address - Country:US
Mailing Address - Phone:281-265-8800
Mailing Address - Fax:
Practice Address - Street 1:16651 SOUTHWEST FWY STE 180
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2346
Practice Address - Country:US
Practice Address - Phone:281-265-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9772208000000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S3980OtherBCBS