MEDICARE: DR. KEVIN MALONEY PT, DPT, SCS, ATC/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251S0007X	Sports Physical Therapist	1248051	TX

General Provider Information

NPI Number	:	1023643517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN MALONEY PT, DPT, SCS, ATC/L

Provider Business Mailing Address
First Line	:	6400 FANNIN ST STE 1620
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1509
Country	:	US
Telephone Number	:	713-704-9602
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 FANNIN ST SUITE 1620
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-7703
Country	:	US
Telephone Number	:	713-704-9602
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2020
Last Update Date	:	02/18/2023

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