Provider Demographics
NPI:1053557090
Name:TAO, CHUNYAO
Entity type:Individual
Prefix:
First Name:CHUNYAO
Middle Name:
Last Name:TAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 BEECHNUT ST
Mailing Address - Street 2:STE 225
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4336
Mailing Address - Country:US
Mailing Address - Phone:713-773-1115
Mailing Address - Fax:713-773-1056
Practice Address - Street 1:7500 BEECHNUT ST
Practice Address - Street 2:STE 225
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4336
Practice Address - Country:US
Practice Address - Phone:713-773-1115
Practice Address - Fax:713-773-1056
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08-221363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical