Provider Demographics
NPI:1295891521
Name:F. R. MALOCH, D.D.S., P.C.
Entity type:Organization
Organization Name:F. R. MALOCH, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:MALOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-797-1731
Mailing Address - Street 1:2304 BARTLETT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-5212
Mailing Address - Country:US
Mailing Address - Phone:713-797-1731
Mailing Address - Fax:713-526-5689
Practice Address - Street 1:2304 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-5212
Practice Address - Country:US
Practice Address - Phone:713-797-1731
Practice Address - Fax:713-526-5689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14951261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental