Individual
MR. CARL HUBERT MALONE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4540 SHERWOOD WAY, SUITE 104A, SAN ANGELO, TX 76901-5619
(325) 947-1505
Mailing address
PO BOX 60251, SAN ANGELO, TX 76906-0251
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4293T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093500902
—
TX
Enumeration date
10/13/2006
Last updated
08/08/2012
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