Provider Demographics
NPI:1225449879
Name:DO, MAI THI
Entity Type:Individual
Prefix:
First Name:MAI
Middle Name:THI
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-5729
Mailing Address - Country:US
Mailing Address - Phone:918-227-7200
Mailing Address - Fax:918-227-6109
Practice Address - Street 1:950 E TAFT AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-5729
Practice Address - Country:US
Practice Address - Phone:918-227-7200
Practice Address - Fax:918-227-6109
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14613183500000X
TX40622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist