MEDICARE: ASIF MALIK

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1669194742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIF MALIK

Provider Business Mailing Address
First Line	:	1367 PORTA ROSA LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2369
Country	:	US
Telephone Number	:	713-502-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	1367 PORTA ROSA LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2369
Country	:	US
Telephone Number	:	713-502-0655
Fax Number	:

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

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	09/14/2022

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Directions to “ ASIF MALIK ” Practice Location

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