Provider Demographics
NPI:1003133604
Name:MI FAMILIA MEDICAL PLLC
Entity Type:Organization
Organization Name:MI FAMILIA MEDICAL PLLC
Other - Org Name:OAKCLIFF
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:MALOUF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-342-5757
Mailing Address - Street 1:9090 SKILLMAN ST
Mailing Address - Street 2:STE 200C
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8263
Mailing Address - Country:US
Mailing Address - Phone:214-342-5757
Mailing Address - Fax:214-340-4868
Practice Address - Street 1:817 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4924
Practice Address - Country:US
Practice Address - Phone:214-941-5777
Practice Address - Fax:214-941-5131
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIFAMILIA MEDICAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-23
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0518208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty