MEDICARE: DR. KHANG VUTUAN BUI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	25430	TX

General Provider Information

NPI Number	:	1730408766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHANG VUTUAN BUI DDS

Provider Business Mailing Address
First Line	:	11403 ASHFORD PNE
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-6179
Country	:	US
Telephone Number	:	832-528-7571
Fax Number	:

Provider Business Practice Location Address
First Line	:	13194 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-5102
Country	:	US
Telephone Number	:	281-530-5050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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