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General NPI Number Information
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NPI Number | 1750550083
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Entity Type | Organization
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Legal Business Name | JOHN M. MALAIN D.P.M., PA
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 3480 FANNIN ST. STE. D
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City | BEAUMONT
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State | TX
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Zip | 77701-3804
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Country | US
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Telephone | 409-832-8800
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Fax | 409-832-6426
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Provider Business Mailing Address
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Address Line | 3480 FANNIN ST. STE. D
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City | BEAUMONT
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State | TX
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Zip | 77701-3804
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Country | US
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Telephone | 409-832-8800
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Fax | 409-832-6426
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TAWNYA ODLE
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Credential |
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Telephone | 409-832-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | P1142
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License Number State | TX
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