Provider Demographics
NPI:1376587568
Name:MAYHUA, PRIMO ABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:PRIMO
Middle Name:ABEL
Last Name:MAYHUA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 310682
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78131-0682
Mailing Address - Country:US
Mailing Address - Phone:830-620-0330
Mailing Address - Fax:830-620-5405
Practice Address - Street 1:1619 E COMMON ST STE 1201
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3464
Practice Address - Country:US
Practice Address - Phone:830-620-0330
Practice Address - Fax:830-620-5405
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM1914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI42893Medicare UPIN
TX8G0081Medicare ID - Type Unspecified