Provider Demographics
NPI:1477012425
Name:MUMA, TAKWI (MD)
Entity type:Individual
Prefix:
First Name:TAKWI
Middle Name:
Last Name:MUMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:903 W MARTIN ST # MS 49-2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-0903
Mailing Address - Country:US
Mailing Address - Phone:201-358-5909
Mailing Address - Fax:210-358-5940
Practice Address - Street 1:8455 CRESTWAY RD
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3527
Practice Address - Country:US
Practice Address - Phone:210-644-2700
Practice Address - Fax:210-702-4623
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXU2581207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine