# MYNURSEPRACTITIONER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** mynp.clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871162016
- **Authorized official:** MR. LARRY D MALONE FNP (NURSE PRACTITIONER/OWNER)
- **Authorized official phone:** (206) 659-7193

## Contact information

- **Practice address:** 539 W COMMERCE ST \# 881, DALLAS, TX 75208-1953
- **Practice address phone:** (206) 659-7193
- **Practice address fax:** (949) 655-7898
- **Mailing address:** 539 W COMMERCE ST \# 881, DALLAS, TX 75208-1953
- **Mailing address phone:** (206) 659-7193
- **Mailing address fax:** (949) 655-7898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2021
- **Last updated:** 06/22/2021