Provider Demographics
NPI:1932487196
Name:JOSEPH, GEORGE MALIAKKAL (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:MALIAKKAL
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14651 DALLAS PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-1651
Mailing Address - Country:US
Mailing Address - Phone:214-483-0123
Mailing Address - Fax:866-482-6883
Practice Address - Street 1:14651 DALLAS PKWY STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-1651
Practice Address - Country:US
Practice Address - Phone:214-483-0123
Practice Address - Fax:866-482-6883
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-21
Last Update Date:2019-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ7214207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology