Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | L5060 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | L5060 | TX |
NPI | 1366439853 |
---|---|
Provider Name | Dr. Stacey C Muhammad |
First Address | Humble, TX 77338 |
Second Address | Humble, TX 77338-4547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 15/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
157538302 | (05) | TX |
H72452 | (02) | TX |