Provider Demographics
NPI:1801009568
Name:DAO, TUAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TUAN
Middle Name:
Last Name:DAO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 S STAPLES ST
Mailing Address - Street 2:STE300
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5505
Mailing Address - Country:US
Mailing Address - Phone:361-850-8000
Mailing Address - Fax:361-850-8001
Practice Address - Street 1:4117 S STAPLES ST
Practice Address - Street 2:STE300
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5505
Practice Address - Country:US
Practice Address - Phone:361-850-8000
Practice Address - Fax:361-850-8001
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2017-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31716122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356186203Medicaid
TX356186203Medicaid