MEDICARE: DR. AMANDA BUI PHARM.D.

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	183500000X	Pharmacist	55269	TX

General Provider Information

NPI Number	:	1760904718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA BUI PHARM.D.

Provider Business Mailing Address
First Line	:	4015 LEMMON AVE STE 4001
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-3737
Country	:	US
Telephone Number	:	12149547389
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 LEMMON AVE STE 4001
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-3737
Country	:	US
Telephone Number	:	214-954-7389
Fax Number	:	855-716-7525

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

Provider Enumeration Date	:	07/12/2017
Last Update Date	:	07/12/2017

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