EID B. MUSTAFA, MD PA
Radiology at Brook Ave, Wichita Falls, TX

License number
Texas G2792
Category
Medical Practice
Type
Surgery of the Hand
License number
Texas G2792
Category
Radiology
Type
Plastic and Reconstructive Surgery
Owner
Name: MRS. DAWN STIVERS
Title: BUSINESS OFFICE
Phone: (940) 322-1122
Address
Address
1201 Brook Ave, Wichita Falls, TX 76301
National Provider ID: 1043302243
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EID B. MUSTAFA, M.D., PA

1201 Brk Ave, Wichita Falls, TX 76301

Doing business as:
Eid B. Mustafa, M.D., PA
Registration:
Apr 4, 2000
State ID:
0082109403
Business type:
Professional Association
Treasurers:
Eid B. Mustafa (Director , Member , President),Saba E. Mustafa (Secretary),Serene E. Mustafa (Treasurer)
Agent:
Eid B Mustafa,1201 Brk Ave, Wichita Falls, TX 76301 (Physical)
TIN:
17528733664

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