Provider Demographics
NPI:1225357403
Name:MALKAWI, KHALID (DDS)
Entity Type:Individual
Prefix:
First Name:KHALID
Middle Name:
Last Name:MALKAWI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 HILLCROFT ST
Mailing Address - Street 2:STE. 106
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-3106
Mailing Address - Country:US
Mailing Address - Phone:810-210-2125
Mailing Address - Fax:
Practice Address - Street 1:6400 HILLCROFT ST
Practice Address - Street 2:STE. 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-3106
Practice Address - Country:US
Practice Address - Phone:810-210-2125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190282831223G0001X
TX00258731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice