MEDICARE: TIMOTHY F. MALONE, DO, PA

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	K1540	TX

General Provider Information

NPI Number	:	1720233430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY F. MALONE, DO, PA

Provider Business Mailing Address
First Line	:	9603 WHITE ROCK TRL
Second Line	:	#110
City	:	DALLAS
State	:	TX
Zip	:	75238-5012
Country	:	US
Telephone Number	:	214-341-8770
Fax Number	:

Provider Business Practice Location Address
First Line	:	9603 WHITE ROCK TRL
Second Line	:	#110
City	:	DALLAS
State	:	TX
Zip	:	75238-5012
Country	:	US
Telephone Number	:	214-341-8770
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TIMOTHY FRANK MALONE
Credential	:	DO
Telephone Number	:	214-341-8770

Provider Enumeration Date	:	11/21/2008
Last Update Date	:	11/21/2008

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