=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407880305
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KHALID MALIK MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2006
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1002 TEXAS BLVD STE 401
-----------------------------------------------------
City | TEXARKANA
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-794-6544
-----------------------------------------------------
Fax | 903-794-6546
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2001 N JEFFERSON AVE
-----------------------------------------------------
City | MOUNT PLEASANT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75455-2338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 903-577-6000
-----------------------------------------------------
Fax | 903-577-6245
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physician
-----------------------------------------------------
License Number | L7026
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------