Individual
DR. ALI L MOUSTAPHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1604 HOSPITAL PKWY, SUITE 301, BEDFORD, TX 76022-6986
(817) 684-9970
(844) 290-4362
Mailing address
1604 HOSPITAL PKWY STE 301, BEDFORD, TX 76022-6931
(817) 684-9970
(844) 290-4362
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M1953
TX
207RI0011X
Interventional Cardiology Physician
M1953
TX
207UN0901X
Nuclear Cardiology Physician
M1953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171594802
—
TX
01
—
8F1173
BCBS
TX
Enumeration date
04/14/2006
Last updated
05/18/2023
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