Hong    Bui    OD
Contract Details
Facility name
Provider ID
P000003818
NPI
1104089101
Tax ID
900535477
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
201 Pasadena Town Square
Pasadena, TX 77506
United States
County
Harris
Phone
7134727392 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Optometry
Map
Address