Organization Active NPI

Mufaddal Medical Consulting PLLC

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1891253381
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MUFADDAL MEDICAL CONSULTING PLLC
Practice address
16125 Cairnway Dr Ste 114
Houston, TX 77084-3556
Phone
(832) 786-8195
Fax
(832) 786-4939
NPI assigned
Mar 4, 2019
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Khuzema Kanchwala
Title
Billing Manager
Phone
(281) 467-1114

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

16125 Cairnway Dr Ste 114
Houston, TX 77084-3556

Mailing address

16103 Kelley Green CT
Cypress, TX 77429-6354
Phone (281) 467-1114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190806000945 TX Part B Supplier - Clinic/Group Practice 8628305265 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, 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
45D2183715Mufaddal Medical Consulting PLLC Dba Aqeeq16125 Cairnway Dr Ste 114, Houston, TX 77084Certificate of waiverMay 7, 2028

National Provider Directory

National Provider Directory

Locations

16125 Cairnway Dr
Ste 114
Houston, TX 77084
Phone (281) 392-1130

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1891253381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16103 KELLEY GREEN CT",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774296354",
            "telephone_number": "281-467-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16125 CAIRNWAY DR STE 114",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770843556",
            "telephone_number": "832-786-8195",
            "fax_number": "832-786-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUFADDAL MEDICAL CONSULTING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-04",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "KANCHWALA",
        "authorized_official_first_name": "KHUZEMA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "281-467-1114"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.