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General NPI Number Information
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NPI Number | 1225263650
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Entity Type | Organization
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Legal Business Name | MALEXA MEDICAL SERVICES
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 03/05/2012
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Provider Practice Location Address
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Address Line | 1521 W MARKET ST SUITE D
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City | ROCKPORT
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State | TX
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Zip | 78382-6218
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Country | US
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Telephone | 361-790-7790
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Fax | 361-790-7785
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Provider Business Mailing Address
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Address Line | PO BOX 1389
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City | ROCKPORT
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State | TX
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Zip | 78381-1389
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Country | US
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Telephone | 361-790-7790
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Fax | 361-790-7785
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARGARET VONHEUVEL
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Credential | GNP
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Telephone | 361-790-7790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State | TX
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