Provider Demographics
NPI:1841220365
Name:DOAN, DAO VAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAO
Middle Name:VAN
Last Name:DOAN
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:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:TX
Mailing Address - Zip Code:77445-0867
Mailing Address - Country:US
Mailing Address - Phone:979-826-3341
Mailing Address - Fax:979-826-8005
Practice Address - Street 1:808 6TH ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:TX
Practice Address - Zip Code:77445-5402
Practice Address - Country:US
Practice Address - Phone:979-826-3341
Practice Address - Fax:979-826-8005
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9180207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0922221 01Medicaid
TX0922221 01Medicaid
TX0035QVMedicare Oscar/Certification
TX00CA66Medicare ID - Type Unspecified
TXC15290Medicare UPIN
TX0035QVMedicare PIN
TX8AJ952Medicare PIN