MEDICARE: HAJRA MOTIWALA PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA12735	TX
2	363AS0400X	Surgical Physician Assistant	PA12735	TX

General Provider Information

NPI Number	:	1306212543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAJRA MOTIWALA PA-C

Provider Business Mailing Address
First Line	:	3550 FM 1092 RD STE A
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2203
Country	:	US
Telephone Number	:	855-748-7246
Fax Number	:	855-592-1107

Provider Business Practice Location Address
First Line	:	3550 FM 1092 RD STE A
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2203
Country	:	US
Telephone Number	:	855-748-7246
Fax Number	:	855-592-1107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	06/03/2026

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Directions to “ HAJRA MOTIWALA PA-C” Practice Location

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