Provider Demographics
NPI:1467554980
Name:MAYMI, JOSUE RADAMES (MED)
Entity Type:Individual
Prefix:MR
First Name:JOSUE
Middle Name:RADAMES
Last Name:MAYMI
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 LOUISIANA ST STE 140
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-9545
Mailing Address - Country:US
Mailing Address - Phone:713-724-1821
Mailing Address - Fax:713-721-6906
Practice Address - Street 1:3401 LOUISIANA ST STE 140
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-9545
Practice Address - Country:US
Practice Address - Phone:713-724-1821
Practice Address - Fax:713-721-6906
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17690101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBCBS 7316LCOtherBLUE CROSS BLUE SHIELD
TX1776056Medicaid