Provider Demographics
NPI:1538124334
Name:MALOUF, CATHY SUE (MD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:SUE
Last Name:MALOUF
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 1:3711 22ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1303
Mailing Address - Country:US
Mailing Address - Phone:806-777-4204
Mailing Address - Fax:
Practice Address - Street 1:3711 22ND ST STE A
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1303
Practice Address - Country:US
Practice Address - Phone:806-777-4204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125627305Medicaid
TX381487Medicare UPIN
G32175Medicare UPIN
TX125627305Medicaid