MEDICARE: MURTAZA MUSSAJI, D.O., P.A.

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	207Q00000X	Family Medicine Physician	M3335	TX
2	207R00000X	Internal Medicine Physician	M3335	TX

General Provider Information

NPI Number	:	1164679494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MURTAZA MUSSAJI, D.O., P.A.

Provider Business Mailing Address
First Line	:	4910 TELEPHONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-3504
Country	:	US
Telephone Number	:	713-641-3900
Fax Number	:	713-641-3901

Provider Business Practice Location Address
First Line	:	4910 TELEPHONE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-3504
Country	:	US
Telephone Number	:	713-641-3900
Fax Number	:	713-641-3901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MURTAZA MUSSAJI
Credential	:	D.O.
Telephone Number	:	713-641-3900

Provider Enumeration Date	:	08/18/2008
Last Update Date	:	08/25/2011

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