Healthcare Provider Details

I. General information

NPI: 1285261180
Provider Name (Legal Business Name): NADIR MULLA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 BROOKS ST STE 215
SUGAR LAND TX
77478-3835
US

IV. Provider business mailing address

1201 BROOKS ST STE 215
SUGAR LAND TX
77478-3835
US

V. Phone/Fax

Practice location:
  • Phone: 346-874-3535
  • Fax: 346-874-3536
Mailing address:
  • Phone: 346-874-3535
  • Fax: 346-874-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberU3953
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberU3953
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: