=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033907605
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | M3 MEDICAL PRACTICE PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2025
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8715 VILLAGE DR STE 510
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78217-5410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-637-0022
-----------------------------------------------------
Fax | 210-654-9840
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19175 KRISTEN WAY
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78258-3624
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-806-3780
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DOCTOR
-----------------------------------------------------
Name | ANGELA MALARCHER
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 954-806-3780
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------