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General NPI Number Information
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NPI Number | 1306987474
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Entity Type | Individual
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Provider Name | MUSTAFA MOHAMMED MOAZAM MD
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 14470 HORIZON BLVD STE J
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City | EL PASO
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State | TX
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Zip | 79928-7696
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Country | US
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Telephone | 832-940-7071
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Fax | 877-761-6002
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Provider Business Mailing Address
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Address Line | 14470 HORIZON BLVD STE J
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City | HORIZON CITY
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State | TX
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Zip | 79928-7696
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Country | US
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Telephone | 915-852-3225
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Fax | 915-209-8289
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.177866
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 036.177866
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N6499
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | N6499
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N6499
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | N6499
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | N6499
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License Number State | TX
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