Healthcare Provider Details

I. General information

NPI: 1477805851
Provider Name (Legal Business Name): MALLEY MEDICAL SERVICE P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 08/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2716 DEERING CT
PLANO TX
75093-3225
US

IV. Provider business mailing address

2716 DEERING CT
PLANO TX
75093-3225
US

V. Phone/Fax

Practice location:
  • Phone: 281-463-6309
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA MALLEY
Title or Position: OWNER
Credential:
Phone: 281-463-6309