MEDICARE: FATIN MUSTAFA

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	363L00000X	Nurse Practitioner	F01260345	TX

General Provider Information

NPI Number	:	1033068598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIN MUSTAFA

Provider Business Mailing Address
First Line	:	19019 LOGAN STAR CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-5764
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19019 LOGAN STAR CT
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-5764
Country	:	US
Telephone Number	:	786-510-8224
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ FATIN MUSTAFA ” Practice Location

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