Tariq S Malik, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04540 Issued in TX

Practice address

700 E Marshall Ave
Longview, TX 75601-5580

Phone

(903) 315-2000

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Acute Care Specialists

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1740655273
  Medicare reassignment
• Northeast Texas Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Longview, TX
  • NPI 1114607611
  Medicare reassignment
• Longview Emergency Medicine Associates PLLC

  • Emergency Medicine Physician
  • Marshall, TX
  • NPI 1902930589

  Physician Assistant

  NPD (past)
• Front Range Emergency Specialists, PC

  • Emergency Medicine Physician
  • Colorado Springs, CO
  • NPI 1538233234
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1912997602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MARSHALL AVE",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015580",
            "telephone_number": "903-315-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "TARIQ",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ugochukwu Ikechi Maduforo, MD
• Madysen House Enterprises
• Leigh Ann Mahjoobi, FNP
• Makona SNF, LLC
• Edward Tamayo Maldonado, C.R.N.A.
• Amy J Malone, PA-C
• Diana Malone, MD
• David W Maly, CRNA
• Soumya Mamidi
• Edgar Ryan Mancilla

• Physician Assistant in Longview, TX
• Providers in Longview, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.