Provider Demographics
NPI:1801023353
Name:KIM K. MAALE, M.D., P.A.
Entity Type:Organization
Organization Name:KIM K. MAALE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAALE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-608-0359
Mailing Address - Street 1:3108 MIDWAY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6383
Mailing Address - Country:US
Mailing Address - Phone:972-608-0359
Mailing Address - Fax:972-608-0605
Practice Address - Street 1:3108 MIDWAY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6383
Practice Address - Country:US
Practice Address - Phone:972-608-0359
Practice Address - Fax:972-608-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2548207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty