Provider Demographics
NPI:1669645727
Name:TAO, JOSHUA DZ-KUAN (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:DZ-KUAN
Last Name:TAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N IH 35
Mailing Address - Street 2:#770
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1804
Mailing Address - Country:US
Mailing Address - Phone:512-482-8880
Mailing Address - Fax:512-482-8862
Practice Address - Street 1:3000 N IH 35
Practice Address - Street 2:#770
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1804
Practice Address - Country:US
Practice Address - Phone:512-482-8880
Practice Address - Fax:512-482-8862
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005019116208000000X
MO20100119262080N0001X
TXP03072080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics