Provider Demographics
NPI:1386215614
Name:BUK, GINA LEE (OD)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:LEE
Last Name:BUK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4909 GATTIS SCHOOL RD
Mailing Address - Street 2:STE 105
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634
Mailing Address - Country:US
Mailing Address - Phone:512-617-3255
Mailing Address - Fax:512-617-3254
Practice Address - Street 1:4909 GATTIS SCHOOL RD
Practice Address - Street 2:STE 105
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-617-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX10190T152W00000X
TX10190TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist