Provider Demographics
NPI:1770770893
Name:BUI, WENDY UYEN (OD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:UYEN
Last Name:BUI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 CORKSCREW PALMS CIR STE 3
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-3307
Mailing Address - Country:US
Mailing Address - Phone:239-948-7555
Mailing Address - Fax:239-948-8077
Practice Address - Street 1:9500 CORKSCREW PALMS CIR STE 3
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-3307
Practice Address - Country:US
Practice Address - Phone:239-948-7555
Practice Address - Fax:239-948-8077
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4266152W00000X
CAOPT13195 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist