Basic Information
| Provider Information | |||||||||
| NPI: | 1376548305 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALOFSKY | ||||||||
| FirstName: | HAROLD | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 900 JEROME ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761043942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177326060 | ||||||||
| FaxNumber: | 8177312541 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 JEROME ST STE 400 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761043942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177326060 | ||||||||
| FaxNumber: | 8177312541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 11/14/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 0523 | TX | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.