Maliakkal, Mammen
Maliakkal, Mammen is an individual health care provider with primary practice located at 3333 N Foster Maldonado Blvd , Eagle Pass TX 78852-5893. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Maliakkal, Mammen can be contacted via phone (830) 773-5321.Contact Information
Primary practice address
3333 N Foster Maldonado Blvd
Eagle Pass TX 78852-5893
Phone: (830) 773-5321
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | N7455 | Texas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | N7455 | Texas |
Profile Details
| NPI number | 1497730816 |
|---|---|
| LBN Legal business name | Maliakkal, Mammen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2005 |
| Last updated | Aug 2nd, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497730816 | NPPES |
| Florida | Other | N371170 | WELLCARE |
| Florida | Other | 14025 | WELLCARE |
| Florida | MEDICAID | 278190500 | WELLCARE |
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