Provider Demographics
NPI:1891357190
Name:HUA, HAO (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAO
Middle Name:
Last Name:HUA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JOHNNY
Other - Middle Name:
Other - Last Name:HUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3532 EISENHOWER ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6050
Mailing Address - Country:US
Mailing Address - Phone:469-835-0682
Mailing Address - Fax:
Practice Address - Street 1:306 HIGHWAY 377 N STE A
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3958
Practice Address - Country:US
Practice Address - Phone:940-464-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice