Provider Demographics
NPI:1932236114
Name:MAI, JENNIFER OANH (DC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:OANH
Last Name:MAI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11360 BELLAIRE BLVD
Mailing Address - Street 2:STE 320
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072
Mailing Address - Country:US
Mailing Address - Phone:281-988-6699
Mailing Address - Fax:281-988-7006
Practice Address - Street 1:11360 BELLAIRE BLVD
Practice Address - Street 2:STE 320
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072
Practice Address - Country:US
Practice Address - Phone:281-988-6699
Practice Address - Fax:281-988-7006
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7997111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC0609118Medicaid
TXC0609118Medicaid