DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1497730816

NPI Code Detail

MEDICARE: DR. MAMMEN MALIAKKAL MD

MEDICARE: DR. MAMMEN MALIAKKAL 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	207R00000X	Internal Medicine Physician	N7455	TX
2	208M00000X	Hospitalist Physician	N7455	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N371170	OTHER	FL	WELLCARE
2	14025	OTHER	FL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497730816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAMMEN MALIAKKAL MD

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-4997
Fax Number	:

Provider Business Practice Location Address
First Line	:	3333 N FOSTER MALDONADO BLVD
Second Line	:
City	:	EAGLE PASS
State	:	TX
Zip	:	78852-5893
Country	:	US
Telephone Number	:	830-773-5321
Fax Number	:

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

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	08/02/2021

Similar Medicare Providers

1477552172 — MR. PETER HOLTZ CRNA
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-773-5321
Practice Fax:

1992767420 — MEI SHEUNG HO CRNA
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-773-5321
Practice Fax:

1235193350 — JUAN MANUEL GONZALEZ CRNA
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-773-5321
Practice Fax:

1437117181 — MAVERICK COUNTY RURAL RADIOLOGISTS P A
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-773-5321
Practice Fax:

1710930938 — MICHAEL S HEINRICH M.D.
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-752-3200
Practice Fax:

1538105580 — BRENDA J PARIS MD
Practice Location Address:

3333 N FOSTER MALDONADO BLVD
EAGLE PASS, TX
78852-5893

Practice Phone: 830-773-5321
Practice Fax:

Directions to “ DR. MAMMEN MALIAKKAL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.