Provider Demographics
NPI:1841667805
Name:ANTHONY J. MUFFOLETTO, MD PA
Entity type:Organization
Organization Name:ANTHONY J. MUFFOLETTO, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MUFFOLETTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-864-3407
Mailing Address - Street 1:1110 NASA PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3345
Mailing Address - Country:US
Mailing Address - Phone:832-864-3047
Mailing Address - Fax:
Practice Address - Street 1:1110 NASA PKWY STE 307
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3345
Practice Address - Country:US
Practice Address - Phone:832-864-3047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty