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Individual

JONATHAN CHARLES MALMROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(818) 269-9567
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
208D00000X
General Practice Physician
Primary
0101283765
VA

Other

Enumeration date
03/20/2023
Last updated
09/17/2024
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