Provider Demographics
NPI:1477599439
Name:MAI, NGHIA DUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:NGHIA DUSTIN
Middle Name:
Last Name:MAI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:DUSTIN
Other - Middle Name:NGHIA
Other - Last Name:MAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1511 N DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3737
Mailing Address - Country:US
Mailing Address - Phone:281-702-1133
Mailing Address - Fax:
Practice Address - Street 1:1511 N DURHAM DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3737
Practice Address - Country:US
Practice Address - Phone:281-702-1133
Practice Address - Fax:713-861-3616
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9082111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU87450Medicare UPIN
TX609651Medicare ID - Type Unspecified