Provider Demographics
NPI:1639849466
Name:NIS MEDICAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NIS MEDICAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-882-4751
Mailing Address - Street 1:3417 SAINT JAMES CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-1893
Mailing Address - Country:US
Mailing Address - Phone:631-882-4751
Mailing Address - Fax:
Practice Address - Street 1:2609 SAGEBRUSH DR STE 101
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-4670
Practice Address - Country:US
Practice Address - Phone:972-539-4875
Practice Address - Fax:972-539-3488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-14
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty