Organization Active NPI

Mustafa Mandviwala, MD, PA

  • Cardiovascular Disease Physician
  • Tomball, TX
National Provider Identifier
1346360997
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MUSTAFA MANDVIWALA, MD, PA
Practice address
13406 Medical Complex Dr
Suite 110
Tomball, TX 77375-3332
Phone
(281) 351-6250
Fax
(281) 351-7841
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Dr. Mustafa Sajjad Mandviwala, MDNPI 1982606448
Title
President
Phone
(281) 351-6250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

13406 Medical Complex Dr
Suite 110
Tomball, TX 77375-3332

Mailing address

13406 Medical Complex Dr
Suite 110
Tomball, TX 77375-3332
Phone (281) 351-6250

Other names 1

  • Northwest Heart Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040406000766 TX Part B Supplier - Clinic/Group Practice 2062405087 Receives reassigned benefits from 2 practitioners
Practice locations: Tomball, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0934233Mustafa Mandviwala MD PA13406 Medical Complex Drive Suite 110, Tomball, TX 77375Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEEIAA

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1346360997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13406 MEDICAL COMPLEX DR",
            "address_2": "SUITE 110",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773753332",
            "telephone_number": "281-351-6250",
            "fax_number": "281-351-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13406 MEDICAL COMPLEX DR",
            "address_2": "SUITE 110",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773753332",
            "telephone_number": "281-351-6250",
            "fax_number": "281-351-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTAFA MANDVIWALA, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "MANDVIWALA",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "SAJJAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-351-6250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Heart Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.