Basic Information
| Provider Information | |||||||||
| NPI: | 1427248970 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MAI | ||||||||
| FirstName: | MINH | ||||||||
| MiddleName: | Q | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13480 VETERANS MEMORIAL DR STE R1 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770141670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815871600 | ||||||||
| FaxNumber: | 2815871601 | ||||||||
| Practice Location | |||||||||
| Address1: | 13480 VETERANS MEMORIAL DR STE R1 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770141670 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815871600 | ||||||||
| FaxNumber: | 2815871601 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2007 | ||||||||
| LastUpdateDate: | 04/17/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | P3763 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | MD.203379 | LA | N | Allopathic & Osteopathic Physicians | Hospitalist | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | P3763 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01031343 | 05 | MS | MEDICAID | 1077615 | 05 | LA | MEDICAID |