Provider Demographics
NPI:1720221799
Name:CAO, HAITAO (PHD, LICAC)
Entity Type:Individual
Prefix:MS
First Name:HAITAO
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:PHD, LICAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 FORTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7620
Mailing Address - Country:US
Mailing Address - Phone:512-445-4444
Mailing Address - Fax:512-444-8091
Practice Address - Street 1:1707 FORTVIEW RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7620
Practice Address - Country:US
Practice Address - Phone:512-707-8828
Practice Address - Fax:512-444-8091
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01057171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist