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NPI Code Detail

MEDICARE: MALIK COLEY

MEDICARE: MALIK COLEY
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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1619714433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALIK COLEY
Provider Business Mailing Address
First Line : 2507 SKYVIEW LONG DR
Second Line :
City : HOUSTON
State : TX
Zip : 77047-8126
Country : US
Telephone Number : 301-747-5556
Fax Number :
Provider Business Practice Location Address
First Line : 5334 PERSHING ST
Second Line :
City : HOUSTON
State : TX
Zip : 77033-2755
Country : US
Telephone Number : 301-747-5556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2024
Last Update Date : 07/10/2024

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Directions to “ MALIK COLEY ” Practice Location

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