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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 14 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 1568421212 NPPES
Texas MEDICAID 157312301
Texas MEDICAID 157312303
Texas MEDICAID 157312302
Texas Other 8A5534
Texas MEDICAID 157312304

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