Healthcare Provider Details

I. General information

NPI: 1033830740
Provider Name (Legal Business Name): APRIL MAE MALON TIU DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2022
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 DODSON ST
MIDLAND TX
79701-6334
US

IV. Provider business mailing address

9305 PRESIDIO PARK DR
HOUSTON TX
77080-1995
US

V. Phone/Fax

Practice location:
  • Phone: 432-687-0235
  • Fax:
Mailing address:
  • Phone: 281-704-0928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1360858
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: