Provider Demographics
NPI:1588443170
Name:MAI, UYENVY PHUONG (APRN)
Entity type:Individual
Prefix:MS
First Name:UYENVY
Middle Name:PHUONG
Last Name:MAI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 W BEN WHITE BLVD STE 210A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7182
Mailing Address - Country:US
Mailing Address - Phone:512-394-0054
Mailing Address - Fax:
Practice Address - Street 1:1221 W BEN WHITE BLVD STE 210A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7182
Practice Address - Country:US
Practice Address - Phone:512-394-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1131625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily