Individual
TU BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5100 N BROOKLINE AVE STE 900, OKLAHOMA CITY, OK 73112-3630
(405) 604-3170
(405) 948-2745
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 604-3170
(405) 948-2745
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
29909
OK
390200000X
Student in an Organized Health Care Education/Training Program
29909
OK
Other
Enumeration date
07/09/2013
Last updated
03/26/2018
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