Provider Demographics
NPI:1740254499
Name:MUSTAFA, ARSHAD (MD)
Entity type:Individual
Prefix:
First Name:ARSHAD
Middle Name:
Last Name:MUSTAFA
Suffix:
Gender:M
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:PO BOX 2347
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6161
Mailing Address - Country:US
Mailing Address - Phone:940-626-8073
Mailing Address - Fax:940-626-8137
Practice Address - Street 1:902 PRESKITT RD STE 600
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-4101
Practice Address - Country:US
Practice Address - Phone:940-626-8073
Practice Address - Fax:940-626-8137
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4987207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342270101Medicaid
TX8EN139OtherBCBS
TX8EN139OtherBCBS