Provider Demographics
NPI:1598993917
Name:DAO, TIFFANY HOAI THU
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:HOAI THU
Last Name:DAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2128
Mailing Address - Country:US
Mailing Address - Phone:817-501-8351
Mailing Address - Fax:
Practice Address - Street 1:3150 WATERSIDE DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2128
Practice Address - Country:US
Practice Address - Phone:817-501-8351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical