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General NPI Number Information
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NPI Number | 1033361068
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Entity Type | Organization
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Legal Business Name | JOHN A. MALONIS, M.D., P.A.
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Dates
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Enumeration Date | 10/22/2008
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 11797 SOUTH FWY STE. 342
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City | BURLESON
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State | TX
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Zip | 76028-7026
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Country | US
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Telephone | 817-926-2663
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Fax | 817-293-8860
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Provider Business Mailing Address
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Address Line | PO BOX 6426
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City | FORT WORTH
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State | TX
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Zip | 76115-0426
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Country | US
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Telephone | 817-926-2663
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Fax | 817-293-8860
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Authorized Official
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Title or Position | A/R SPECIALIST
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Name | MRS. MARY BARCUCH
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Credential |
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Telephone | 817-926-2663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H9542
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License Number State | TX
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