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NPI Code Detail

MEDICARE: DR. SHAURAT RAMJI MALIK DDS

MEDICARE: DR. SHAURAT RAMJI MALIK DDS
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
11223G0001XGeneral Practice Dentistry19587TX

General Provider Information

NPI Number : 1790876639
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAURAT RAMJI MALIK DDS
Provider Business Mailing Address
First Line : 4840 SWEETWATER BLVD STE A
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3403
Country : US
Telephone Number : 281-240-0400
Fax Number :
Provider Business Practice Location Address
First Line : 4840 SWEETWATER BLVD
Second Line : SUITE A
City : SUGAR LAND
State : TX
Zip : 77479-3153
Country : US
Telephone Number : 281-240-0400
Fax Number : 281-240-0407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 11/13/2008

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