Provider Demographics
NPI:1285014688
Name:BUI, ALLEN
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:
Last Name:BUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HUNG
Other - Middle Name:THANH
Other - Last Name:BUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:129 RUE LOUIS XIV
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-5738
Mailing Address - Country:US
Mailing Address - Phone:337-289-9700
Mailing Address - Fax:337-289-9702
Practice Address - Street 1:129 RUE LOUIS XIV
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-5738
Practice Address - Country:US
Practice Address - Phone:337-289-9700
Practice Address - Fax:337-289-9702
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL382512086S0129X
LA3223762086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1285014688OtherNPI