Provider Demographics
NPI:1336674589
Name:MAINOO, JOI (RN, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:JOI
Middle Name:
Last Name:MAINOO
Suffix:
Gender:F
Credentials:RN, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2789 SUNLIGHT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-7615
Mailing Address - Country:US
Mailing Address - Phone:469-952-8215
Mailing Address - Fax:
Practice Address - Street 1:2789 SUNLIGHT DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-7615
Practice Address - Country:US
Practice Address - Phone:469-952-8215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT81162255A2300X
TXNA0060041634376K00000X
TX390200000X
TX1014362163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No376K00000XNursing Service Related ProvidersNurse's Aide
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program