Provider Demographics
NPI:1861580623
Name:RAO, ASHOO M (MD)
Entity type:Individual
Prefix:
First Name:ASHOO
Middle Name:M
Last Name:RAO
Suffix:
Gender:F
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:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:4405 RIVER OAKS BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76114-2326
Practice Address - Country:US
Practice Address - Phone:817-624-1770
Practice Address - Fax:817-625-1287
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3735208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089911404Medicaid
TXTXB132388Medicare PIN
TX5439501OtherAETNA PIN
TX023481701Medicaid
TX00U87ZOtherBCBSTX GRP PIN
TX089911403Medicaid
TX140442863Medicaid
F24737Medicare UPIN
TX86V838OtherBCBSTX IND PIN
TX137283101Medicaid
TX122111100OtherFIRSTCARE PIN
TXRAOAF24737OtherCCHIP PIN
TX6238563OtherCIGNA PIN
TX1392596OtherUHC PIN
TX00L46SMedicare ID - Type UnspecifiedGRP MEDICARE
TX86V838Medicare ID - Type UnspecifiedIND MEDICARE
TX089911401Medicaid