Provider Demographics
NPI:1538426135
Name:MUSTAFA, NADA FURQAAN (MD)
Entity type:Individual
Prefix:
First Name:NADA
Middle Name:FURQAAN
Last Name:MUSTAFA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NADA
Other - Middle Name:
Other - Last Name:MOHAMMAD RIAZUDDIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:909 FROSTWOOD DR STE 1.100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4492
Mailing Address - Fax:
Practice Address - Street 1:17500 W GRAND PKWY S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:281-725-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6773207R00000X, 208M00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX488800YT8BOtherMEDICARE
TX1805421OtherCIGNA
TX357144006Medicaid
TX8FR588OtherBCBS TX
TX357144007Medicaid
TX357144001OtherMEDICAID
TX357144005Medicaid
TX4188657OtherAETNA