Healthcare Provider Details

I. General information

NPI: 1275823858
Provider Name (Legal Business Name): HUSSEIN B MUSA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2011
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5282 MEDICAL DR SUITE 200
SAN ANTONIO TX
78229-4849
US

IV. Provider business mailing address

18626 HARDY OAK BLVD SUITE 300
SAN ANTONIO TX
78258-4210
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-6432
  • Fax: 210-615-3586
Mailing address:
  • Phone: 210-495-9047
  • Fax: 210-293-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberQ3559
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License NumberQ3559
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: