Basic Information
| Provider Information | |||||||||
| NPI: | 1588977284 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MALBAS | ||||||||
| FirstName: | MARJORIE ANN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10260 N CENTRAL EXPY # 100N | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752313437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612494247 | ||||||||
| FaxNumber: | 3143627641 | ||||||||
| Practice Location | |||||||||
| Address1: | 10260 N CENTRAL EXPY # 100N | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752313437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3612494247 | ||||||||
| FaxNumber: | 3147473963 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2010 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP1-0038280 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | P8695 | TX | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207RE0101X | 2015019328 | MO | N | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207R00000X | P8695 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.