Basic Information
| Provider Information | |||||||||
| NPI: | 1194747253 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALINOWSKI | ||||||||
| FirstName: | DOROTA | ||||||||
| MiddleName: | MALGORZATA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MALINOWSKA | ||||||||
| OtherFirstName: | DOROTA | ||||||||
| OtherMiddleName: | MALGORZATA | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4118 POND HILL RD BLDG 3 | ||||||||
| Address2: | |||||||||
| City: | SHAVANO PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782311281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104943739 | ||||||||
| FaxNumber: | 2104902164 | ||||||||
| Practice Location | |||||||||
| Address1: | 4118 POND HILL RD BLDG 3 | ||||||||
| Address2: | |||||||||
| City: | SHAVANO PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782311281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104943739 | ||||||||
| FaxNumber: | 2104902164 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 03/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | N3857 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | P00754980 | 01 | TX | RRMC | OTHER |