Provider Demographics
NPI:1154511871
Name:MUSTAFA, MUHAMMAD SHAHID (MD)
Entity Type:Individual
Prefix:
First Name:MUHAMMAD
Middle Name:SHAHID
Last Name:MUSTAFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14781 MEMORIAL DR
Mailing Address - Street 2:SUITE 1598
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5210
Mailing Address - Country:US
Mailing Address - Phone:261-668-7702
Mailing Address - Fax:
Practice Address - Street 1:14781 MEMORIAL DR
Practice Address - Street 2:SUITE 1598
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5210
Practice Address - Country:US
Practice Address - Phone:261-668-7702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK25412084N0400X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
F53952Medicare UPIN