Provider Demographics
NPI:1013952746
Name:TSAO, JERRY Y (MD)
Entity type:Individual
Prefix:DR
First Name:JERRY
Middle Name:Y
Last Name:TSAO
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 1:7850 PARKWOOD CIRCLE DR STE A-6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-6760
Mailing Address - Country:US
Mailing Address - Phone:713-772-8885
Mailing Address - Fax:713-772-7825
Practice Address - Street 1:7850 PARKWOOD CIRCLE DR STE A-6
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-6760
Practice Address - Country:US
Practice Address - Phone:713-772-8885
Practice Address - Fax:713-772-7825
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-17
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6779207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AJ335OtherBLUE CROSS BLUE SHIELD
TX096478502Medicaid
TX096478502Medicaid
00Y543Medicare PIN