MEDICARE: SRINI MALINI 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	2085R0202X	Diagnostic Radiology Physician	F0113	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00BR18	OTHER	TX	BLUE CROSS BLUE SHEILD

General Provider Information

NPI Number	:	1447251202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRINI MALINI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 710561
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77271-0561
Country	:	US
Telephone Number	:	713-795-5672
Fax Number	:	713-795-5809

Provider Business Practice Location Address
First Line	:	8200 WEDNESBURY LN
Second Line	:	SUITE 320
City	:	HOUSTON
State	:	TX
Zip	:	77074-2925
Country	:	US
Telephone Number	:	713-795-5672
Fax Number	:	713-795-5809

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

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	04/28/2008

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Directions to “ SRINI MALINI M.D.” Practice Location

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