Provider Demographics
NPI:1205270923
Name:MUSA, RAWAN MUSTAFA (MD)
Entity type:Individual
Prefix:
First Name:RAWAN
Middle Name:MUSTAFA
Last Name:MUSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-1173
Mailing Address - Country:US
Mailing Address - Phone:409-772-6576
Mailing Address - Fax:409-772-9068
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1173
Practice Address - Country:US
Practice Address - Phone:409-772-6576
Practice Address - Fax:409-772-9068
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10047038207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine