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NPI Code Detail

MEDICARE: AMY BOPHA BUN PMHNP

MEDICARE: AMY BOPHA BUN PMHNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerRN2364619MA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner82241KS
3363LP0808XPsychiatric/Mental Health Nurse Practitioner1096814TX

General Provider Information

NPI Number : 1144951195
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY BOPHA BUN PMHNP
Provider Business Mailing Address
First Line : 4443 BRANDEMERE WAY ST
Second Line :
City : HOUSTON
State : TX
Zip : 77066-3618
Country : US
Telephone Number : 832-868-5600
Fax Number :
Provider Business Practice Location Address
First Line : 9825 EAGLE DR
Second Line :
City : MONT BELVIEU
State : TX
Zip : 77523-9847
Country : US
Telephone Number : 409-267-4126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2022
Last Update Date : 07/22/2025

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