Healthcare Provider Details

I. General information

NPI: 1477726172
Provider Name (Legal Business Name): MOHAMMAD ANSAR MUGHAL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 10/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 SW 36TH ST
SAN ANTONIO TX
78237-3360
US

IV. Provider business mailing address

PO BOX 87
SAN ANTONIO TX
78291-0087
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-5100
  • Fax: 210-358-5157
Mailing address:
  • Phone: 210-358-9172
  • Fax: 210-358-9183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP0049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: