Provider Demographics
NPI:1255651279
Name:MAI, VINH TUAN (MD)
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:TUAN
Last Name:MAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 NAPLES LN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3019
Mailing Address - Country:US
Mailing Address - Phone:817-715-8810
Mailing Address - Fax:
Practice Address - Street 1:222 LAS COLINAS BLVD W STE 135
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5402
Practice Address - Country:US
Practice Address - Phone:214-574-2443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7947207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine