Individual
GHOLAMREZA MALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A81941
CA
2085R0202X
Diagnostic Radiology Physician
Primary
K9841
TX
2085R0204X
Vascular & Interventional Radiology Physician
K9841
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-0622723
TAX ID #
—
05
—
153145101
—
TX
01
—
8G6010
BCBS OF TX #
TX
Enumeration date
12/15/2005
Last updated
01/25/2023
Update your record
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