Provider Demographics
NPI:1669738787
Name:MAI, JOHNNY PHUONG VAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:PHUONG VAN
Last Name:MAI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20631 KUYKENDAHL RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3318
Mailing Address - Country:US
Mailing Address - Phone:281-453-1001
Mailing Address - Fax:281-803-5515
Practice Address - Street 1:9301 PINECROFT DR STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3178
Practice Address - Country:US
Practice Address - Phone:281-364-1001
Practice Address - Fax:281-364-9095
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2024-09-13
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Provider Licenses
StateLicense IDTaxonomies
TXR8234207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology