Mallat, Damien B
Mallat, Damien B is an individual health care provider with primary practice located at 7777 Forest Ln Bldg. C Suite 204, Dallas TX 75230-2571. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mallat, Damien B can be contacted via phone (972) 566-5266.Contact Information
Primary practice address
7777 Forest Ln Bldg. C Suite 204
Dallas TX 75230-2571
Phone: (972) 566-5266
Fax: (972) 566-5245
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | L0393 | Texas |
Profile Details
NPI number | 1568421212 |
---|---|
LBN Legal business name | Mallat, Damien B |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 21st, 2006 |
Last updated | Nov 20th, 2012 - about 12 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 | 1568421212 | NPPES |
Texas | MEDICAID | 157312301 | |
Texas | MEDICAID | 157312303 | |
Texas | MEDICAID | 157312302 | |
Texas | Other | 8A5534 | |
Texas | MEDICAID | 157312304 |
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