Healthcare Provider Details

I. General information

NPI: 1134009319
Provider Name (Legal Business Name): TAMNHU BUI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2025
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 CROWN CT STE 201
WOODBRIDGE VA
22193-1463
US

IV. Provider business mailing address

14000 CROWN CT STE 201
WOODBRIDGE VA
22193-1463
US

V. Phone/Fax

Practice location:
  • Phone: 403-499-8787
  • Fax: 703-499-8222
Mailing address:
  • Phone: 403-499-8787
  • Fax: 703-499-8222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: