Provider Demographics
NPI:1639481179
Name:HAO QUANG DO DPM, PC
Entity Type:Organization
Organization Name:HAO QUANG DO DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAO
Authorized Official - Middle Name:QUANG
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, PC
Authorized Official - Phone:915-591-9070
Mailing Address - Street 1:1850 HUNTER DR.
Mailing Address - Street 2:STE. 107
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1549
Mailing Address - Country:US
Mailing Address - Phone:915-591-9070
Mailing Address - Fax:915-591-8108
Practice Address - Street 1:1850 HUNTER DR.
Practice Address - Street 2:STE. 107
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1549
Practice Address - Country:US
Practice Address - Phone:915-591-9070
Practice Address - Fax:915-591-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1407213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX280014601Medicaid
TXTXB114113Medicare PIN
TX280014601Medicaid
TX1242140001Medicare NSC