Bree Ann Malcoff
Individual provider Active NPI Technician · Garden Ridge, TX
NPI 1801008701 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801008701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Technician 374700000X
- License
- 5540-05 (CA)
- Practice address
- 18945 FM 2252
Ste 115
Garden Ridge, TX 78266-2797 - Phone
- (210) 651-0029
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5540-05 | CA | MD | Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | 5540-05 | CA | Yes |
Addresses
Primary practice location
18945 FM 2252
Ste 115
Garden Ridge, TX 78266-2797
Mailing address
2280 Cloverdale Rd
Escondido, CA 92027-6914
Phone (760) 715-4856
Other providers in Garden Ridge, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.