Provider Demographics
NPI:1487670543
Name:MUSA POPENEY, WAFA (DO)
Entity Type:Individual
Prefix:
First Name:WAFA
Middle Name:
Last Name:MUSA POPENEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:FAYE
Other - Middle Name:
Other - Last Name:MUSA-POPENEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2655 CORDES DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1353
Mailing Address - Country:US
Mailing Address - Phone:281-980-3311
Mailing Address - Fax:281-980-9344
Practice Address - Street 1:2655 CORDES DR STE 110
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1353
Practice Address - Country:US
Practice Address - Phone:281-980-3311
Practice Address - Fax:281-980-9344
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00465GOtherBLUECROSS BLUESHIELD
TX00465GOtherBLUECROSS BLUESHIELD