MEDICARE: TERESA BUI

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1942907977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA BUI

Provider Business Mailing Address
First Line	:	9301 E US HIGHWAY 290 APT 338
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78724-2617
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 W 2ND ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-4652
Country	:	US
Telephone Number	:	888-880-9270
Fax Number	:

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

Provider Enumeration Date	:	02/09/2023
Last Update Date	:	02/09/2023

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Directions to “ TERESA BUI ” Practice Location

Language	Start Address	Practice Location

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