MEDICARE: MUSTAFA AL-BAYATI 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	W1371	TX

General Provider Information

NPI Number	:	1871172122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUSTAFA AL-BAYATI M.D.

Provider Business Mailing Address
First Line	:	1400 S COULTER ST STE 2500
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1786
Country	:	US
Telephone Number	:	806-414-9100
Fax Number	:	806-354-5717

Provider Business Practice Location Address
First Line	:	1400 S COULTER ST STE 2500
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79106-1786
Country	:	US
Telephone Number	:	806-414-9100
Fax Number	:	806-354-5717

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

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	05/20/2026

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