Eid B. Mustafa, MD PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

G2792 Issued in TX

Legal business name

EID B. MUSTAFA, MD PA

Practice address

1201 Brook Avenue
Wichita Falls, TX 76301-5601

Phone

(940) 322-1122

Fax

(940) 767-8918

NPI assigned

Sep 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Dawn Stivers

Title

Business Office

Phone

(940) 322-1122

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eid B Mustafa, MD

  • Plastic and Reconstructive Surgery Physician
  • Wichita Falls, TX
  • NPI 1023018470

  Plastic and Reconstructive Surgery, TX

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1043302243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 BROOK AVENUE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015601",
            "telephone_number": "940-322-1122",
            "fax_number": "940-767-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BROOK AVENUE",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015601",
            "telephone_number": "940-322-1122",
            "fax_number": "940-767-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EID B. MUSTAFA, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "STIVERS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS OFFICE",
        "authorized_official_telephone_number": "940-322-1122",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "TX",
            "license": "G2792",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "G2792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE IDENTIFIER",
            "identifier": "240006708",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171591401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya Lynn Egloff, DDS
• Eh of Fort Worth, LP
• Eh of Fort Worth, LP
• Katryna Ehlinger
• Eid B. Mustafa
• Susann Edith Eirosius, LCSW
• Vivian Chidinma Ekechukwu, DO
• Sara Elchehabi, DO
• Karen Leann Elder
• Salesha Elkins

• All providers in Wichita Falls, TX
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.