Willie-Musoma, Katrina L

Willie-Musoma, Katrina L is an individual health care provider with primary practice located at 2800 E Broad St Ste 100 , Mansfield TX 76063-6410. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities. Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities is her primary health care specialty. Willie-Musoma, Katrina L can be contacted via phone (817) 557-5437.

Contact Information

Primary practice address
2800 E Broad St Ste 100 Mansfield TX 76063-6410
Phone: (817) 557-5437
Fax: (817) 539-0476
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M9742 Texas
Allopathic & Osteopathic Physicians / Neurodevelopmental Disabilities 2080P0008X M9742 Texas

Profile Details

NPI number 1003023979
LBN Legal business name Willie-Musoma, Katrina L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Dec 28th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003023979 NPPES
Other 00R86C MEDICARE GROUP NPI
Other 084933301 MEDICARE GROUP NPI
MEDICAID 195476005 MEDICARE GROUP NPI

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