Provider Demographics
NPI:1376272807
Name:K MALKAWI DDS PA
Entity Type:Organization
Organization Name:K MALKAWI DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:
Authorized Official - Last Name:MALKAWI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-984-7400
Mailing Address - Street 1:1147 CLEAR LAKE CITY BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-8102
Mailing Address - Country:US
Mailing Address - Phone:281-984-7410
Mailing Address - Fax:346-230-7957
Practice Address - Street 1:1147 CLEAR LAKE CITY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-8102
Practice Address - Country:US
Practice Address - Phone:281-984-7410
Practice Address - Fax:346-230-7957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty