MEDICARE: THAO NGOC 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	39340	TX

General Provider Information

NPI Number	:	1053910414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THAO NGOC BUI

Provider Business Mailing Address
First Line	:	6055 FRY RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-1801
Country	:	US
Telephone Number	:	281-858-7613
Fax Number	:	281-855-7547

Provider Business Practice Location Address
First Line	:	6055 FRY RD
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-1801
Country	:	US
Telephone Number	:	281-858-7613
Fax Number	:	281-855-7547

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

Provider Enumeration Date	:	10/17/2020
Last Update Date	:	10/17/2020

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Directions to “ THAO NGOC BUI ” Practice Location

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