Provider Demographics
NPI:1982702031
Name:CAO, KHOA T (MD)
Entity Type:Individual
Prefix:DR
First Name:KHOA
Middle Name:T
Last Name:CAO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11034 SCARSDALE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-6068
Mailing Address - Country:US
Mailing Address - Phone:281-484-0449
Mailing Address - Fax:281-484-7210
Practice Address - Street 1:11034 SCARSDALE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-6068
Practice Address - Country:US
Practice Address - Phone:281-484-0449
Practice Address - Fax:281-484-7210
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2023-07-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK7428207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111953904Medicaid
TXG97520Medicare UPIN