Provider Demographics
NPI:1235311986
Name:TRUNG DAO MD, PA
Entity Type:Organization
Organization Name:TRUNG DAO MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:DAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-234-4994
Mailing Address - Street 1:399 W CAMPBELL RD
Mailing Address - Street 2:SUITE #212
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3606
Mailing Address - Country:US
Mailing Address - Phone:972-234-4994
Mailing Address - Fax:972-234-4412
Practice Address - Street 1:399 W CAMPBELL RD
Practice Address - Street 2:SUITE #212
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3606
Practice Address - Country:US
Practice Address - Phone:972-234-4994
Practice Address - Fax:972-234-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK0013207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1798944-01Medicaid
TX00049ZMedicare PIN
TXF41991Medicare UPIN