Individual
DR. JOHN MARTIN MALONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1119 S 31ST ST, TEMPLE, TX 76504-5214
(254) 773-3248
(254) 773-5576
Mailing address
406 CHEROKEE DR, TEMPLE, TX 76504-3628
(254) 295-6202
(254) 773-5576
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3499T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093261803
—
TX
01
—
75-2307858
FED EMPLOYER ID #
TX
Enumeration date
02/01/2006
Last updated
08/19/2009
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