Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mustafa Mustafa, DPM

Individual provider Foot & Ankle Surgery Podiatrist · NPI 1104529015

Mustafa Mustafa, DPM is a Podiatry in Southlake, Texas. Graduated from Kent State University College of Podiatric Medicine in 2023, 3 years ago. Works from 2 locations. Licensed in Texas.

Years since qualifying
3
Trained at
Kent State University College of Podiatric Medicine
Licensed in
TX
In the registry since
2023
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

1940 E State Highway 114
Southlake, TX 76092-6526
Phone: (817) 424-3668
Fax: (817) 442-8637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 22201 Moross Rd Ste 250, Detroit, MI 48236-2175 — (313) 343-3423

Specialties & licences

Foot & Ankle Surgery Podiatrist (primary) Taxonomy 213ES0103X · Licence 692306 (TX)

Record details

NPI number1104529015
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedMarch 22, 2023
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026
Mailing address1940 E State Highway 114, Southlake, TX 76092-6526

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolKENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Southlake