MEDICARE: ROBIN DENISE MALLETT 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	2084P0804X	Child & Adolescent Psychiatry Physician	J7570	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	:	1336150465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN DENISE MALLETT M.D.

Provider Business Mailing Address
First Line	:	7510 F. M. 1765
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591
Country	:	US
Telephone Number	:	409-935-6083
Fax Number	:	409-935-0818

Provider Business Practice Location Address
First Line	:	7510 F. M. 1765
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77591
Country	:	US
Telephone Number	:	409-935-6083
Fax Number	:	409-935-0818

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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