Subodh K Mallik, M.D.
Individual provider Active NPI Internal Medicine Physician · Fort Stockton, TX
NPI 1689628885 · NPPES record last updated Oct 9, 2013
Key facts
- NPI
- 1689628885
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- K4945 (TX)
- Practice address
- 387 W Ih 10
Fort Stockton, TX 79735-2700 - Phone
- (432) 336-0700
- Fax
- (432) 336-0704
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 13
Hospital & facility affiliations 13
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- County of Ward
Practice addresses (Care Compare)
921 E 4TH St
Sandhills Fam Clin E
Monahans, TX 79756-4016
Phone (432) 943-2057
Hospital & facility affiliations
- Express Nursing
- St Josephs Home Health Inc
- Excelacare Home Health
- Home Hospice
- Heart to Heart Hospice of Permian Basin
- Ward Memorial Hospital
- Pecos County Memorial Hospital
- Medical Center Hospital
- Midland Memorial Hospital
- Avir at Monahans
- Focused Care at Fort Stockton
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Avir at Monahans |
Skilled nursing facility | Operational/Managerial Control Adp of the SNF |
Mar 1, 2025 Mar 1, 2025 |
| Focused Care at Fort Stockton |
Skilled nursing facility | Adp of the SNF | Nov 1, 2017 |
| Sandhills Family Clinic East |
Rural health clinic | Corporate Director W-2 Managing Employee |
Jan 2, 2018 Jan 2, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051025000890 | TX | Practitioner - Internal Medicine |
5496772808 |
Reassigns benefits to 4 organizations Practice locations: Fort Stockton, TX; Odessa, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Ward | Current | Accepting new patients | |
| County of Ward | Current |
Accepting new patients | |
| County of Ward | Current |
Accepting new patients | |
| County of Ward | Current | Accepting new patients | |
| Seminole Hospital District of Gaines County Texas | Current |
Accepting new patients | |
| Seminole Hospital District of Gaines County Texas | Current |
Accepting new patients | |
| Bir Hospital LLC | Current | Accepting new patients | |
| Ess of South Texas LLC | Current |
Accepting new patients | |
| Subodh K Mallik, MD, PA | Past |
Accepting new patients | |
| Midland County Hospital District | Past | Accepting new patients | |
| Midland County Hospital District | Past | Accepting new patients |
Locations
387 W Interstate 10
Fort Stockton, TX 79735
Phone (432) 336-2004
1353 N Travis St
Liberty, TX 77575
Phone (936) 336-7316
921 E 4th St
Monahans, TX 79756
Phone (432) 923-7052
813 E 4th St
Monahans, TX 79756
Phone (432) 943-2068
406 S Gary Ave
Monahans, TX 79756
Phone (432) 943-2511
1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611
209 NW 8th St
Seminole, TX 79360
Phone (432) 758-5811
Interoperability endpoints
- subodh.mallik.1@13131.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | K4945 | TX | Yes |
Addresses
Primary practice location
387 W Ih 10
Fort Stockton, TX 79735-2700
Mailing address
387 W Ih 10
Fort Stockton, TX 79735-2700
Phone (432) 336-0700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111902608 | Medicaid | TX |
Other providers in Fort Stockton, TX
- Mark A Hudson
- Jay Shree Meladi Maa, LLC
- Napaporn Jessadapagorn
- Josephine L Jordan
- Kamelia Morgan Lamm
- Marquez Anesthesia PLLC
- Genaro Hinojos Marquez
- Med-Trans Corporation
- Cristian Alejandro Medina
- Midland County Hospital District
All providers in Fort Stockton, TX · Internal Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.