NPIMap

Organization Active NPI

Subodh K Mallik MD PA

  • Rural Health Clinic/Center
  • Fort Stockton, TX
National Provider Identifier
1477847234
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SUBODH K MALLIK MD PA
Practice address
2071 N Main St
Fort Stockton, TX 79735-3041
Phone
(432) 336-0700
NPI assigned
Jun 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Subodh MallikNPI 1689628885
Title
Dr./Owner
Phone
(432) 336-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2071 N Main St
Fort Stockton, TX 79735-3041

Mailing address

2071 N Main St
Fort Stockton, TX 79735-3041

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307491200000",
    "number": "1477847234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2071 N MAIN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797353041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2071 N MAIN ST",
            "city": "FORT STOCKTON",
            "state": "TX",
            "postal_code": "797353041",
            "telephone_number": "432-336-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBODH K MALLIK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A",
        "authorized_official_last_name": "MALLIK",
        "authorized_official_first_name": "SUBODH",
        "authorized_official_title_or_position": "DR./OWNER",
        "authorized_official_telephone_number": "432-336-0700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stockton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.