Provider Demographics
| NPI: | 1194793851 |
|---|---|
| Name: | VEJLANI, MUSTANSIR (MD) |
| Entity type: | Individual |
| Prefix: | |
| First Name: | MUSTANSIR |
| Middle Name: | |
| Last Name: | VEJLANI |
| Suffix: | |
| Gender: | M |
| Credentials: | MD |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 721 JAMES ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | TOMBALL |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 77375-4537 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 281-351-5600 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 721 JAMES ST |
| Practice Address - Street 2: | |
| Practice Address - City: | TOMBALL |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 77375-4537 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 281-351-5600 |
| Practice Address - Fax: | |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2006-03-09 |
| Last Update Date: | 2022-08-31 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| TX | K1116 | 207RP1001X, 207QS1201X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 207QS1201X | Allopathic & Osteopathic Physicians | Family Medicine | Sleep Medicine |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 152796201 | Medicaid | |
| TX | 826B47 | Other | MEDICARE GROUP NUMBER |
| TX | 826B47 | Other | MEDICARE GROUP NUMBER |
| TX | 152796201 | Medicaid |