Provider Demographics
NPI:1073576401
Name:BUI, HUNGANH (MD)
Entity Type:Individual
Prefix:DR
First Name:HUNGANH
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W PARK STE 104
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8337
Mailing Address - Country:US
Mailing Address - Phone:936-328-5820
Mailing Address - Fax:936-328-5840
Practice Address - Street 1:210 W PARK STE 104
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8337
Practice Address - Country:US
Practice Address - Phone:936-328-5820
Practice Address - Fax:936-328-5840
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1036207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173349503Medicaid
TX8DT280OtherBLUE CROSS BLUE SHIELD
TXP00247384Medicare PIN
TX173349503Medicaid
TXI18822Medicare UPIN