=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285014688
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLEN T BUI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2015
-----------------------------------------------------
Last Update Date | 03/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 129 RUE LOUIS XIV
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508-5738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-289-9700
-----------------------------------------------------
Fax | 337-289-9702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 129 RUE LOUIS XIV
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508-5738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-289-9700
-----------------------------------------------------
Fax | 337-289-9702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | LL38251
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 322376
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------