Organization Active NPI

Mai Medical

  • Internal Medicine Physician
  • Stafford, TX
National Provider Identifier
1972205656
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAI MEDICAL
Practice address
4807 Sugar Grove Blvd Ste 302
Stafford, TX 77477-2654
Phone
(713) 999-2860
Fax
(713) 999-2689
NPI assigned
Mar 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Monica Trevino
Title
Manager
Phone
(832) 604-9944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4807 Sugar Grove Blvd Ste 302
Stafford, TX 77477-2654

Mailing address

4807 Sugar Grove Blvd Ste 302
Stafford, TX 77477-2654
Phone (713) 999-2860

Other practice location 1

3648 Cypress Creek Pkwy Ste 240
Houston, TX 77068-3609
Phone (832) 604-9944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231201000016 TX Part B Supplier - Clinic/Group Practice 8921456997 Receives reassigned benefits from 2 practitioners
Practice locations: Stafford, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2289523Mai Medical PA4807 Sugar Grove Blvd Suite 301, Stafford, TX 77477Certificate of waiverSep 11, 2027

National Provider Directory

National Provider Directory

Locations

3648 Cypress Creek Pkwy
Ste 240
Houston, TX 77068
Phone (832) 604-9944

4807 Sugar Grove Blvd
Ste 302
Stafford, TX 77477
Phone (713) 999-2860

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1972205656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4807 SUGAR GROVE BLVD STE 302",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772654",
            "telephone_number": "713-999-2860",
            "fax_number": "713-999-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 SUGAR GROVE BLVD STE 302",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774772654",
            "telephone_number": "713-999-2860",
            "fax_number": "713-999-2689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3648 Cypress Creek Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770683609",
            "country_code": "US",
            "telephone_number": "832-604-9944",
            "fax_number": "713-424-4899",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAI MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "832-604-9944"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.