Provider Demographics
NPI:1497150064
Name:MAI VIET CARE INC.
Entity Type:Organization
Organization Name:MAI VIET CARE INC.
Other - Org Name:MY VIET HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-360-5209
Mailing Address - Street 1:PO BOX 594
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-0594
Mailing Address - Country:US
Mailing Address - Phone:469-360-5209
Mailing Address - Fax:817-953-8892
Practice Address - Street 1:2416 LAKEWOOD DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-6800
Practice Address - Country:US
Practice Address - Phone:469-360-5209
Practice Address - Fax:817-953-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care