Malone, Amy J
Malone, Amy J is an individual health care provider with primary practice located at 1300 N 4Th St , Longview TX 75601-4717. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Malone, Amy J can be contacted via phone (903) 757-6042.Contact Information
Primary practice address
1300 N 4Th St
Longview TX 75601-4717
Phone: (903) 757-6042
Fax: (903) 758-1801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA0124 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA01024 | Texas |
Profile Details
| NPI number | 1063412468 |
|---|---|
| LBN Legal business name | Malone, Amy J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Jul 28th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063412468 | NPPES |
| Texas | MEDICAID | 204712803 | |
| Texas | MEDICAID | 361638502 | |
| Texas | MEDICAID | 204712805 |
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