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NPI Code Detail

MEDICARE: MRS. DEBREKA SHENETTE MALONE

MEDICARE:  MRS. DEBREKA SHENETTE MALONE
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
1363LF0000XFamily Nurse Practitioner2018002325GA
2363LF0000XFamily Nurse Practitioner2018002325TX
3363LF0000XFamily Nurse Practitioner2018002325LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306341250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBREKA SHENETTE MALONE
Provider Business Mailing Address
First Line : 2310 SUMMER WIND DR
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-7021
Country : US
Telephone Number : 281-414-8776
Fax Number :
Provider Business Practice Location Address
First Line : 3375 WESTPARK DR STE C
Second Line :
City : HOUSTON
State : TX
Zip : 77005-4262
Country : US
Telephone Number : 281-487-0402
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2018
Last Update Date : 04/16/2026

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Directions to “ MRS. DEBREKA SHENETTE MALONE ” Practice Location

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