Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 0401415314 | VA |
Y | 213EG0000X | General Practice | 0401415314 | VA |
NPI | 1003362591 |
---|---|
Provider Name | Minh Bui |
First Address | Rosenberg, TX 77471-5985 |
Second Address | Rosenberg, TX 77471-5985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2016 |
Last Update Date | 02/02/2019 |