MEDICARE: TI AN BUI NP

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	363LF0000X	Family Nurse Practitioner	C-RXN.0102695-C-NP	CO
2	363LF0000X	Family Nurse Practitioner	1176535	TX
3	163W00000X	Registered Nurse	984338	TX

General Provider Information

NPI Number	:	1356179105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TI AN BUI NP

Provider Business Mailing Address
First Line	:	448 CASTROVILLE RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-5147
Country	:	US
Telephone Number	:	210-434-1400
Fax Number	:	210-431-7472

Provider Business Practice Location Address
First Line	:	1555 S WADSWORTH BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80232-6832
Country	:	US
Telephone Number	:	303-985-1597
Fax Number	:

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

Provider Enumeration Date	:	07/23/2024
Last Update Date	:	09/13/2025

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