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NPI Code Detail

MEDICARE: AYATULLAH MOSTAFA

MEDICARE: AYATULLAH MOSTAFA
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1144155987
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYATULLAH MOSTAFA
Provider Business Mailing Address
First Line : 4350 PINE BLOSSOM TRL
Second Line :
City : HOUSTON
State : TX
Zip : 77059-3254
Country : US
Telephone Number : 901-591-3241
Fax Number :
Provider Business Practice Location Address
First Line : 1515 HOLCOMBE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77030-4009
Country : US
Telephone Number : 877-632-6789
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ AYATULLAH MOSTAFA ” Practice Location

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