Basic Information
| Provider Information | |||||||||
| NPI: | 1104262799 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | QUYNHBUIMD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14507 WISTERIA HOLLOW LN | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770622355 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4401 GARTH RD | ||||||||
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| City: | BAYTOWN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775212122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814208600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2013 | ||||||||
| LastUpdateDate: | 05/22/2013 | ||||||||
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| AuthorizedOfficialLastName: | BUI | ||||||||
| AuthorizedOfficialFirstName: | QUYNH-UYEN | ||||||||
| AuthorizedOfficialMiddleName: | THI | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7138501190 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | L6303 | TX | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207R00000X | L6303 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.