Provider Demographics
NPI:1598781205
Name:MALAKOFF, AARON F (MD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:F
Last Name:MALAKOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E EDGEWATER TER
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-4005
Mailing Address - Country:US
Mailing Address - Phone:830-624-1511
Mailing Address - Fax:830-624-1511
Practice Address - Street 1:127 E EDGEWATER TER
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4005
Practice Address - Country:US
Practice Address - Phone:830-624-1511
Practice Address - Fax:830-624-1511
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5092208800000X
TXD 5092208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXO344210 01Medicaid
TX00K702Medicare ID - Type Unspecified
TXO344210 01Medicaid