Provider Demographics
NPI:1457559254
Name:THAI, QUI H (MD)
Entity Type:Individual
Prefix:
First Name:QUI
Middle Name:H
Last Name:THAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6090 S FORT APACHE RD
Mailing Address - Street 2:145
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5617
Mailing Address - Country:US
Mailing Address - Phone:702-877-1688
Mailing Address - Fax:702-877-1888
Practice Address - Street 1:6090 S FORT APACHE RD
Practice Address - Street 2:145
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5617
Practice Address - Country:US
Practice Address - Phone:702-877-1688
Practice Address - Fax:702-877-1888
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11488207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV1069OtherBLUECROSS
NV100507145Medicaid
NVNV1069OtherBLUECROSS
NVV101926Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE