Provider Demographics
NPI:1932209525
Name:BUI, LINDA L (OD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
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 1:1901 MANHATTAN BLVD
Mailing Address - Street 2:SUITE F-107
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-3582
Mailing Address - Country:US
Mailing Address - Phone:504-362-5214
Mailing Address - Fax:504-362-5224
Practice Address - Street 1:1901 MANHATTAN BLVD
Practice Address - Street 2:SUITE F-107
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3582
Practice Address - Country:US
Practice Address - Phone:504-362-5214
Practice Address - Fax:504-362-5224
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1386-522T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1706060Medicaid