Provider Demographics
NPI:1992987283
Name:CAO, WEIWEI (MD, PHD)
Entity type:Individual
Prefix:
First Name:WEIWEI
Middle Name:
Last Name:CAO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 E HIGHWAY 290
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-483-9569
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:1401 MEDICAL PKWY BLDG. B STE. 200
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5013
Practice Address - Country:US
Practice Address - Phone:512-260-1581
Practice Address - Fax:512-406-7309
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110717207R00000X
TXQ0614207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX339995802Medicaid
TX339995803Medicaid