MEDICARE: MALLORY HOFFMAN M.D.

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	207VM0101X	Maternal & Fetal Medicine Physician	35.134798	OH
2	207V00000X	Obstetrics & Gynecology Physician	35.134798	OH
3	207VM0101X	Maternal & Fetal Medicine Physician	01089150A	IN
4	207VM0101X	Maternal & Fetal Medicine Physician	51848	KY

General Provider Information

NPI Number	:	1972865475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORY HOFFMAN M.D.

Provider Business Mailing Address
First Line	:	6410 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	832-325-7288
Fax Number	:	713-383-1464

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	832-325-7288
Fax Number	:	713-383-1464

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

Provider Enumeration Date	:	06/11/2012
Last Update Date	:	12/02/2025

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