MEDICARE: DURDANA ASIF MALIK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	K3793	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184734261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DURDANA ASIF MALIK MD

Provider Business Mailing Address
First Line	:	4207 JAMES CASEY STREET
Second Line	:	SUITE #111
City	:	AUSTIN
State	:	TX
Zip	:	78745-3362
Country	:	US
Telephone Number	:	512-444-9800
Fax Number	:	512-444-9820

Provider Business Practice Location Address
First Line	:	4207 JAMES CASEY STREET
Second Line	:	SUITE #111
City	:	AUSTIN
State	:	TX
Zip	:	78745-3362
Country	:	US
Telephone Number	:	512-444-9800
Fax Number	:	512-444-9820

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	04/27/2014

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