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NPI Code Detail

MEDICARE: QUINTELLA MALLORY

MEDICARE: QUINTELLA MALLORY
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
1163W00000XRegistered Nurse830389TX

General Provider Information

NPI Number : 1730830332
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUINTELLA MALLORY
Provider Business Mailing Address
First Line : 16806 HARBOR FALLS DR
Second Line :
City : CYPRESS
State : TX
Zip : 77433-0179
Country : US
Telephone Number : 254-415-2316
Fax Number :
Provider Business Practice Location Address
First Line : 1999 BRYAN ST STE 900
Second Line :
City : DALLAS
State : TX
Zip : 75201-3140
Country : US
Telephone Number : 254-415-2316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2022
Last Update Date : 02/03/2023

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Directions to “ QUINTELLA MALLORY ” Practice Location

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