MEDICARE: ARTHUR DAVID MALLINSON LPC' MDIV, MRE

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	101YP2500X	Professional Counselor	67120	TX

General Provider Information

NPI Number	:	1942552690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR DAVID MALLINSON LPC' MDIV, MRE

Provider Business Mailing Address
First Line	:	5242 TURTLE COVE RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-4930
Country	:	US
Telephone Number	:	972-365-3513
Fax Number	:

Provider Business Practice Location Address
First Line	:	5242 TURTLE COVE RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-4930
Country	:	US
Telephone Number	:	972-365-3513
Fax Number	:

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

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	10/04/2012

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