MEDICARE: DR. MUSTAFA FIROZ M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	K9527	TX
2	208M00000X	Hospitalist Physician	K9527	TX
3	207R00000X	Internal Medicine Physician	K9527	TX

General Provider Information

NPI Number	:	1720040686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MUSTAFA FIROZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 93090
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-1090
Country	:	US
Telephone Number	:	903-873-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 S 4TH ST
Second Line	:	SUITE A
City	:	WILLS POINT
State	:	TX
Zip	:	75169-2632
Country	:	US
Telephone Number	:	903-873-3330
Fax Number	:

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

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	08/16/2023

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Directions to “ DR. MUSTAFA FIROZ M.D.” Practice Location

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