Provider Demographics
NPI:1790150910
Name:CAO, DONG (LAC)
Entity Type:Individual
Prefix:
First Name:DONG
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20811 FIGURINE CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7070
Mailing Address - Country:US
Mailing Address - Phone:832-866-2501
Mailing Address - Fax:
Practice Address - Street 1:440 COBIA DR STE 1104
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7159
Practice Address - Country:US
Practice Address - Phone:832-866-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01618171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist