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General NPI Number Information
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NPI Number | 1295891521
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Entity Type | Organization
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Legal Business Name | F. R. MALOCH, D.D.S., P.C.
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2304 BARTLETT ST
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City | HOUSTON
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State | TX
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Zip | 77098-5212
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Country | US
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Telephone | 713-797-1731
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Fax | 713-526-5689
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Provider Business Mailing Address
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Address Line | 2304 BARTLETT ST
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City | HOUSTON
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State | TX
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Zip | 77098-5212
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Country | US
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Telephone | 713-797-1731
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Fax | 713-526-5689
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. FREDERICK RICHARD MALOCH
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Credential | D.D.S.
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Telephone | 713-797-1731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 14951
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License Number State | TX
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