Individual
MARIAM MOUTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-1930
(254) 724-2111
(254) 724-7603
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10046407
TX
2084N0400X
Neurology Physician
Primary
Q8576
TX
Other
Enumeration date
06/04/2013
Last updated
07/30/2018
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