Individual
DR. DOMINIC MALIAKKAL JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDPA
Contact information
Practice address
9401 SOUTHWEST FWY, HOUSTON, TX 77074-1407
(713) 970-3354
Mailing address
2026 VALLERIA CT, SUGAR LAND, TX 77479-5568
(281) 265-8056
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J1278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131226604
—
TX
05
—
131226605
—
TX
05
—
131226606
—
TX
01
—
260044914
RAIL ROAD
TX
01
—
260044915
RAIL ROAD
TX
01
—
89406S
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/20/2006
Last updated
10/19/2020
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