Provider Demographics
NPI:1003099813
Name:MALIK, HENNA MUKHTAR (MD)
Entity Type:Individual
Prefix:
First Name:HENNA
Middle Name:MUKHTAR
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9201 PINECROFT DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3222
Mailing Address - Country:US
Mailing Address - Phone:281-298-2876
Mailing Address - Fax:
Practice Address - Street 1:13215 DOTSON RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4535
Practice Address - Country:US
Practice Address - Phone:281-894-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01064564A207R00000X
TXM8807207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01843060OtherRAILROAD
TX281930205Medicaid
TX281930206Medicaid
TX549806YKYCMedicare PIN
TXP01843060OtherRAILROAD
TXTXB146197Medicare PIN
TX281930206Medicaid