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General NPI Number Information
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NPI Number | 1104090760
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Entity Type | Organization
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Legal Business Name | LAWRENCE E MALLETTE, MD, PA
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 08/11/2009
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Provider Practice Location Address
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Address Line | 8200 WEDNESBURY LN STE 105
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City | HOUSTON
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State | TX
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Zip | 77074-2925
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Country | US
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Telephone | 713-271-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 2028 DRYDEN RD
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City | HOUSTON
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State | TX
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Zip | 77030-1206
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Country | US
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Telephone | 713-271-2030
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Fax | 713-271-2351
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE E MALLETTE
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Credential | MD, PHD
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Telephone | 713-271-2030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | E4891
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License Number State | TX
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