Provider Demographics
NPI:1629721915
Name:GULAMHUSEIN, MUSTAFA H
Entity Type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:H
Last Name:GULAMHUSEIN
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 1:27721 TOMBALL PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6579
Mailing Address - Country:US
Mailing Address - Phone:832-698-1565
Mailing Address - Fax:
Practice Address - Street 1:27721 TOMBALL PKWY STE 400
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6579
Practice Address - Country:US
Practice Address - Phone:832-698-1565
Practice Address - Fax:832-698-4598
Is Sole Proprietor?:No
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist