Individual
KATRINA L WILLIE-MUSOMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 COOPER ST, FORT WORTH, TX 76104-2710
(682) 303-9300
(682) 303-9245
Mailing address
PO BOX 733784, DALLAS, TX 75373-3784
(682) 885-6483
(682) 885-3113
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
M9742
TX
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
M9742
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R86C
MEDICARE GROUP NPI
—
01
—
084933301
TMHP/MEDICAID GROUP TPI
TX
05
—
195476005
—
TX
Enumeration date
05/17/2007
Last updated
02/24/2026
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