Provider Demographics
NPI:1558849018
Name:MAI, ALICIA (RCEP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MAI
Suffix:
Gender:F
Credentials:RCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 WESTCOTT ST APT 507
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-6367
Mailing Address - Country:US
Mailing Address - Phone:347-682-1894
Mailing Address - Fax:
Practice Address - Street 1:920 WESTCOTT ST APT 507
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-6367
Practice Address - Country:US
Practice Address - Phone:347-682-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74234673224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist