Provider Demographics
NPI:1255690145
Name:KOU, DANIEL W (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:KOU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 FM 423 APT 342
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0515
Mailing Address - Country:US
Mailing Address - Phone:716-704-9314
Mailing Address - Fax:
Practice Address - Street 1:3250 W PLEASANT RUN RD
Practice Address - Street 2:#190
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1050
Practice Address - Country:US
Practice Address - Phone:469-765-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice