Provider Demographics
NPI: | 1144493891 |
---|---|
Name: | DAO CAMPI, HAISAR EDUARDO (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | HAISAR |
Middle Name: | EDUARDO |
Last Name: | DAO CAMPI |
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: | 7703 FLOYD CURL DR |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN ANTONIO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78229-3901 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 210-450-9200 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4211 N JACKSON RD |
Practice Address - Street 2: | |
Practice Address - City: | MCALLEN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78504-6907 |
Practice Address - Country: | US |
Practice Address - Phone: | 956-365-4400 |
Practice Address - Fax: | 956-365-4111 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2008-04-02 |
Last Update Date: | 2024-05-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | Q8458 | 208C00000X, 207RG0100X, 208C00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 208C00000X | Allopathic & Osteopathic Physicians | Colon & Rectal Surgery | |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 363451101 | Medicaid | |
TX | 363451102 | Other | CSHCN |
TX | 530469YK00 | Medicare UPIN |