Provider Demographics
NPI:1477853232
Name:MAI, QUYNH TU
Entity Type:Individual
Prefix:MS
First Name:QUYNH
Middle Name:TU
Last Name:MAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 S DURANGO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3605
Mailing Address - Country:US
Mailing Address - Phone:702-407-2524
Mailing Address - Fax:702-407-2524
Practice Address - Street 1:7405 S DURANGO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3605
Practice Address - Country:US
Practice Address - Phone:702-407-2524
Practice Address - Fax:702-407-2516
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist