Provider Demographics
NPI:1659524007
Name:MALAMUD, KENNETH LESTER (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LESTER
Last Name:MALAMUD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1001 BUCHANAN DR STE 3
Mailing Address - Street 2:
Mailing Address - City:BURNET
Mailing Address - State:TX
Mailing Address - Zip Code:78611-2329
Mailing Address - Country:US
Mailing Address - Phone:512-715-3937
Mailing Address - Fax:512-715-3938
Practice Address - Street 1:1001 BUCHANAN DR STE 3
Practice Address - Street 2:
Practice Address - City:BURNET
Practice Address - State:TX
Practice Address - Zip Code:78611-2329
Practice Address - Country:US
Practice Address - Phone:512-715-3937
Practice Address - Fax:512-715-3938
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2009-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG1707207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659524007OtherNPI