Provider Demographics
NPI:1609901750
Name:MAI, MICHELLE A (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:A
Last Name:MAI
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:9211 WEST RD
Mailing Address - Street 2:STE. 137
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-8633
Mailing Address - Country:US
Mailing Address - Phone:832-237-8088
Mailing Address - Fax:832-237-8028
Practice Address - Street 1:9211 WEST RD
Practice Address - Street 2:STE. 137
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-8633
Practice Address - Country:US
Practice Address - Phone:832-237-8088
Practice Address - Fax:832-237-8028
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX5506152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU85433Medicare UPIN