Provider Demographics
NPI:1477615706
Name:MALONEY, KEVIN M (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:MALONEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 PROTON RD STE 110
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75244-3507
Mailing Address - Country:US
Mailing Address - Phone:214-641-3640
Mailing Address - Fax:972-239-4091
Practice Address - Street 1:4220 PROTON RD STE 110
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75244-3507
Practice Address - Country:US
Practice Address - Phone:214-641-3640
Practice Address - Fax:972-239-4091
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU96941Medicare UPIN