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Individual
HOA K BUI
Active
Individual
HOA K BUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20730
TX
1223G0001X
General Practice Dentistry
Primary
20730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154204501
—
TX
Enumeration date
08/05/2006
Last updated
05/31/2021
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