Provider Demographics
NPI:1679289383
Name:MALONE, LOIS A
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:A
Last Name:MALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10919 TULIP GARDEN CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3230
Mailing Address - Country:US
Mailing Address - Phone:832-603-0462
Mailing Address - Fax:
Practice Address - Street 1:25718 SERENE SPRING LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8464
Practice Address - Country:US
Practice Address - Phone:281-770-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider