Provider Demographics
NPI:1154430254
Name:MALATY CORPORATION
Entity type:Organization
Organization Name:MALATY CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:WAHBA
Authorized Official - Last Name:MALATY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:281-561-6410
Mailing Address - Street 1:10523 HERALD SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1811
Mailing Address - Country:US
Mailing Address - Phone:281-561-6410
Mailing Address - Fax:281-575-0567
Practice Address - Street 1:10523 HERALD SQUARE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1811
Practice Address - Country:US
Practice Address - Phone:281-561-6410
Practice Address - Fax:281-575-0567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0033359332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100187824001OtherUNITED HEALTH CARE
TX82-00041OtherMEDICAID(EVERCARE)
TX100187824001OtherUNITED HEALTH CARE