MEDICARE: DOROTA MALGORZATA MALINOWSKI M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	N3857	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00754980	OTHER	TX	RRMC

General Provider Information

NPI Number	:	1194747253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOROTA MALGORZATA MALINOWSKI M.D.

Provider Business Mailing Address
First Line	:	4118 POND HILL RD BLDG 3
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1281
Country	:	US
Telephone Number	:	210-494-3739
Fax Number	:	210-490-2164

Provider Business Practice Location Address
First Line	:	4118 POND HILL RD BLDG 3
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1281
Country	:	US
Telephone Number	:	210-494-3739
Fax Number	:	210-490-2164

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	03/21/2017

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