Buna Medical Clinic

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

BUNA MEDICAL CLINIC

Practice address

35607 Hwy 96 South
Buna, TX 77612-6600

Phone

(409) 994-9323

Fax

(409) 994-9290

NPI assigned

Apr 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lara D West

Title

Billing Manager

Phone

(409) 994-9323

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GAYLE A PUGH Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Rural health clinic certification: CCN 673844

Legal name

BUNA MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Oct 15, 2002

Last certification

Jul 18, 2017

Ownership / control type

1A

Organization structure

OtherProprietary

Incorporated

in TX

Enrollment address

35607 Highway 96 S
Buna, TX 77612-6600

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Gayle A Pugh

  • Physician Assistant
  • Buna, TX
  • NPI 1184653354

  O20060404000063

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Gayle A Pugh

  • Physician Assistant
  • Buna, TX
  • NPI 1184653354

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Huang, D.O.

  • Family Medicine Physician
  • Hacienda Heights, CA
  • NPI 1104902295
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1306066568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2279",
            "city": "BUNA",
            "state": "TX",
            "postal_code": "776122279",
            "telephone_number": "409-994-9323",
            "fax_number": "409-994-9290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35607 HWY 96 SOUTH",
            "city": "BUNA",
            "state": "TX",
            "postal_code": "776126600",
            "telephone_number": "409-994-9323",
            "fax_number": "409-994-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUNA MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "LARA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "409-994-9323",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID TX HEALTH STEPS",
            "identifier": "153391103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153391101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAYLE A PUGH",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Austin Pharmacy
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• Holly Buchanan
• Buna Isd
• Buna Pharmacy LLC
• Ceaettas Family Services , LLC
• Ceaettas Family Services, LLC
• Community Birth Group
• Khristy Franklin Denin

• Rural Health Clinic/Center in Buna, TX
• Providers in Buna, TX by specialty
• Rural Health Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.