Provider Demographics
NPI:1912381146
Name:CAO, JESSE (DC)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:CAO
Suffix:
Gender:M
Credentials:DC
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 3105
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77588-3105
Mailing Address - Country:US
Mailing Address - Phone:346-479-1209
Mailing Address - Fax:
Practice Address - Street 1:2743 SMITH RANCH RD UNIT 1301
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5219
Practice Address - Country:US
Practice Address - Phone:346-479-1209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor