Provider Demographics
NPI:1386918159
Name:CHRISTINA M BUI MD PA
Entity type:Organization
Organization Name:CHRISTINA M BUI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-688-9257
Mailing Address - Street 1:PO BOX 761269
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-6269
Mailing Address - Country:US
Mailing Address - Phone:210-688-9257
Mailing Address - Fax:210-568-4045
Practice Address - Street 1:10919 CULEBRA RD
Practice Address - Street 2:SUITE 122
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253
Practice Address - Country:US
Practice Address - Phone:210-688-9257
Practice Address - Fax:210-568-4045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7070207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX294368001Medicaid
TXTXB148652Medicare PIN
TX294368001Medicaid