Provider Demographics
NPI:1235208430
Name:CAO, HIEP A (MD)
Entity Type:Individual
Prefix:DR
First Name:HIEP
Middle Name:A
Last Name:CAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2912
Mailing Address - Country:US
Mailing Address - Phone:580-256-9263
Mailing Address - Fax:580-256-9267
Practice Address - Street 1:1824 KANSAS AVE
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2912
Practice Address - Country:US
Practice Address - Phone:580-256-9263
Practice Address - Fax:580-256-9267
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21116207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKH22601Medicare UPIN
OK$$$$$$$$$Medicare PIN