Active NPI
Mai Thanh-Thuy Nguyen, M.D.
- Nephrology Physician
- Jbsa Ft Sam Houston, TX
National Provider Identifier
1396752747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- N2687
- Practice address
- 3551 Roger Brooke Dr
Brooke Army Medical Center, McHe-QD (Credentialing)
Jbsa Ft Sam Houston, TX 78234-4504 - Phone
- (210) 916-1455
- Fax
- (210) 916-3585
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 87535 | FL | |
| Internal Medicine Physician | 207R00000X | N2687 | TX | |
| Nephrology Physician | 207RN0300X | N2687 | TX | Primary |
| Pediatrics Physician | 208000000X | 87535 | FL | |
| Pediatric Nephrology Physician | 2080P0210X | N2687 | TX |
Addresses
Primary practice location
3551 Roger Brooke Dr
Brooke Army Medical Center, McHe-QD (Credentialing)
Jbsa Ft Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Brooke Army Medical Center, McHe-QD (Credentialing)
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-1455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 87535 | FL | MD | Internal Medicine Physician |
| N2687 | TX | MD | Pediatric Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1396752747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"address_2": "BROOKE ARMY MEDICAL CENTER, MCHE-QD (CREDENTIALING)",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-1455",
"fax_number": "210-916-3585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"address_2": "BROOKE ARMY MEDICAL CENTER, MCHE-QD (CREDENTIALING)",
"city": "JBSA FT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-1455",
"fax_number": "210-916-3585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "MAI",
"middle_name": "THANH-THUY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "87535",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "N2687",
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "TX",
"license": "N2687",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "87535",
"primary": false
},
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "TX",
"license": "N2687",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Ft Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.