Provider Demographics
NPI:1699905125
Name:BUI, AN THAI (OD)
Entity type:Individual
Prefix:DR
First Name:AN
Middle Name:THAI
Last Name:BUI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 PENDLETON AVE STE C0006
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE LEWIS MCCHORD
Mailing Address - State:WA
Mailing Address - Zip Code:98433-1672
Mailing Address - Country:US
Mailing Address - Phone:253-964-4140
Mailing Address - Fax:
Practice Address - Street 1:5280 PENDLETON AVE STE C0006
Practice Address - Street 2:
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98433-1672
Practice Address - Country:US
Practice Address - Phone:253-964-4140
Practice Address - Fax:253-964-1696
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61339746152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist