Provider Demographics
NPI:1174526560
Name:DAO, TIMOTHY P (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:P
Last Name:DAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 RITA LN
Mailing Address - Street 2:STE 105
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2010
Mailing Address - Country:US
Mailing Address - Phone:817-465-4141
Mailing Address - Fax:817-465-9714
Practice Address - Street 1:501 RITA LN
Practice Address - Street 2:STE 105
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2010
Practice Address - Country:US
Practice Address - Phone:817-465-4141
Practice Address - Fax:817-465-9714
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195138601Medicaid
TX00514KMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TX195138601Medicaid
TX8K8407Medicare PIN