Provider Demographics
NPI:1811558158
Name:DAO, ALEJANDRA THI (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:THI
Last Name:DAO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3247 DAWES DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-5760
Mailing Address - Country:US
Mailing Address - Phone:214-330-7767
Mailing Address - Fax:
Practice Address - Street 1:3247 DAWES DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-5760
Practice Address - Country:US
Practice Address - Phone:214-330-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant