Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 16484 | TX |
NPI | 1104846278 |
---|---|
Provider Name | Dr. Tina T Bui |
First Address | Humble, TX 77346 |
Second Address | Humble, TX 77346-2252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |