MEDICARE: DR. THANG Q. BUI OD

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	152W00000X	Optometrist	1783	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588701601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THANG Q. BUI OD

Provider Business Mailing Address
First Line	:	416 N ROCK RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2211
Country	:	US
Telephone Number	:	316-722-7376
Fax Number	:	316-652-0512

Provider Business Practice Location Address
First Line	:	416 N ROCK RD
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67206-2240
Country	:	US
Telephone Number	:	316-722-7376
Fax Number	:	316-652-0512

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	11/13/2018

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