Provider Demographics
NPI:1982994182
Name:HV CAO MEDICAL CLINIC, LLC
Entity Type:Organization
Organization Name:HV CAO MEDICAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIEP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:580-628-7716
Mailing Address - Street 1:3465 W WALNUT ST
Mailing Address - Street 2:SUITE 211B
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7153
Mailing Address - Country:US
Mailing Address - Phone:580-628-7716
Mailing Address - Fax:
Practice Address - Street 1:3465 W WALNUT ST
Practice Address - Street 2:SUITE 211B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7153
Practice Address - Country:US
Practice Address - Phone:580-628-7716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty