Provider Demographics
NPI:1750722997
Name:DAO, KIM LE (DPM)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:LE
Last Name:DAO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5625 EIGER RD
Mailing Address - Street 2:STE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-8978
Mailing Address - Country:US
Mailing Address - Phone:512-447-4122
Mailing Address - Fax:
Practice Address - Street 1:5625 EIGER RD
Practice Address - Street 2:STE 110
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8978
Practice Address - Country:US
Practice Address - Phone:512-447-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2239213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX363000601Medicaid
TX363000601Medicaid