Malakouti, Mazyar

Malakouti, Mazyar is an individual health care provider with primary practice located at 505 S Nolen Dr Ste A , Southlake TX 76092-9167. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Malakouti, Mazyar can be contacted via phone (817) 424-1525.

Contact Information

Primary practice address
505 S Nolen Dr Ste A Southlake TX 76092-9167
Phone: (817) 424-1525
Fax: (817) 424-3491
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X R1079 Texas
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X R1079 Texas
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X R1079 Texas

Profile Details

NPI number 1962845305
LBN Legal business name Malakouti, Mazyar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2013
Last updated Jul 9th, 2019 - about 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962845305 NPPES
Texas MEDICAID 371268901
Texas Other 371268902

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