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General NPI Number Information
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NPI Number | 1568428381
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Entity Type | Organization
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Legal Business Name | MESQUITE HEART CENTER, P.A.
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1601 N. BELT LINE RD. SUITE C
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City | MESQUITE
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State | TX
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Zip | 75149-1791
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Country | US
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Telephone | 972-279-3500
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Fax | 972-279-3505
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Provider Business Mailing Address
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Address Line | PO BOX 850347
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City | MESQUITE
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State | TX
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Zip | 75185-0347
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Country | US
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Telephone | 972-279-3500
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Fax | 972-279-3505
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SALEEM H MALLICK
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Credential | M.D.
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Telephone | 972-279-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | E6487
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License Number State | TX
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