Provider Demographics
NPI:1467152389
Name:HAVER, MALEK KRCO (FNP-C)
Entity type:Individual
Prefix:
First Name:MALEK
Middle Name:KRCO
Last Name:HAVER
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5373 W ALABAMA ST STE 204
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-5923
Mailing Address - Country:US
Mailing Address - Phone:713-338-9386
Mailing Address - Fax:877-298-7013
Practice Address - Street 1:5373 W ALABAMA ST STE 204
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-5923
Practice Address - Country:US
Practice Address - Phone:713-338-9386
Practice Address - Fax:877-298-7013
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX942839163W00000X
TX1138338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse