Provider Demographics
NPI:1376763680
Name:CALVIN N TSAO MD PA
Entity Type:Organization
Organization Name:CALVIN N TSAO MD PA
Other - Org Name:IMPRESSIONS LASER AND COSMETICS MEDSPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CALVIN
Authorized Official - Middle Name:NIEN-FONG
Authorized Official - Last Name:TSAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-772-8885
Mailing Address - Street 1:7850 PARKWOOD CIRCLE DR
Mailing Address - Street 2:STE A6
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6759
Mailing Address - Country:US
Mailing Address - Phone:713-772-8885
Mailing Address - Fax:713-772-7825
Practice Address - Street 1:7850 PARKWOOD CIRCLE DR
Practice Address - Street 2:STE A6
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-6759
Practice Address - Country:US
Practice Address - Phone:713-772-8885
Practice Address - Fax:713-772-7825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2162207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ711OtherBLUECROSS BLUESHIELD
TX612591Medicare ID - Type Unspecified
TXI61289Medicare UPIN