Provider Demographics
NPI:1891253381
Name:MUFADDAL MEDICAL CONSULTING PLLC
Entity Type:Organization
Organization Name:MUFADDAL MEDICAL CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KHUZEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-467-1114
Mailing Address - Street 1:16103 KELLEY GREEN CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6354
Mailing Address - Country:US
Mailing Address - Phone:281-467-1114
Mailing Address - Fax:
Practice Address - Street 1:19121 W LITTLE YORK RD STE B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-5841
Practice Address - Country:US
Practice Address - Phone:832-858-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty