Provider Demographics
NPI:1598188575
Name:ALANI, MUSTAFA
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:
Last Name:ALANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 MCPHERSON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-2813
Mailing Address - Country:US
Mailing Address - Phone:956-267-8511
Mailing Address - Fax:956-267-8498
Practice Address - Street 1:7807 MCPHERSON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-2813
Practice Address - Country:US
Practice Address - Phone:956-267-8511
Practice Address - Fax:956-267-8498
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29619122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist