Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 87535 | FL |
N | 111NI0900X | Internist | 87535 | FL |
N | 207R00000X | Internist | N2687 | TX |
N | 111NI0900X | Internist | N2687 | TX |
Y | 207RN0300X | Nephrologist | N2687 | TX |
N | 208000000X | Pediatrician | 87535 | FL |
N | 2080P0210X | Pediatric Nephrologist | N2687 | TX |
NPI | 1396752747 |
---|---|
Provider Name | Mai Thanh-Thuy Nguyen |
First Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Second Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 18/05/2015 |