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NPI Code Detail

MEDICARE: GARRY MALONE

MEDICARE:   GARRY  MALONE
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
1171W00000XContractorTX

General Provider Information

NPI Number : 1205222056
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRY MALONE
Provider Business Mailing Address
First Line : 8206 LETTIE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77075-4722
Country : US
Telephone Number : 281-222-5832
Fax Number : 832-767-5732
Provider Business Practice Location Address
First Line : 6720 BELLFORT ST
Second Line :
City : HOUSTON
State : TX
Zip : 77087-6412
Country : US
Telephone Number : 713-643-0433
Fax Number : 832-767-5732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2015
Last Update Date : 04/08/2015

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Directions to “ GARRY MALONE ” Practice Location

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