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Individual

JEREMY CHIP MALOUF

Active
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Individual

JEREMY CHIP MALOUF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
549804
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
R3709
TX
208600000X
Surgery Physician
33671
SC
208600000X
Surgery Physician
BP1 0036959
TX

Other

Enumeration date
05/17/2010
Last updated
06/11/2019
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