Provider Demographics
NPI:1821224320
Name:MALONE, EDWIN ROBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:ROBERT
Last Name:MALONE
Suffix:JR
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 1:13706 BLAIR HILL LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1283
Mailing Address - Country:US
Mailing Address - Phone:504-606-2284
Mailing Address - Fax:
Practice Address - Street 1:22999 U.S. 59
Practice Address - Street 2:KINGWOOD MEDICAL CENTER
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-348-8560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5205207P00000X
IL125056564207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine