Provider Demographics
NPI:1730318569
Name:BUI, PETER TAN (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:TAN
Last Name:BUI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ROSA AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3414
Mailing Address - Country:US
Mailing Address - Phone:504-510-5510
Mailing Address - Fax:504-510-5119
Practice Address - Street 1:110 ROSA AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3414
Practice Address - Country:US
Practice Address - Phone:504-510-5510
Practice Address - Fax:504-510-5119
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1506111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor