Organization
MESQUITE HEART CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALEEM H MALLICK M.D. (PRESIDENT)
(972) 552-5110
Entity
Organization
Contact information
Practice address
763 E US HIGHWAY 80, SUITE 110, FORNEY, TX 75126-8633
(972) 552-5110
Mailing address
PO BOX 850347, MESQUITE, TX 75185-0347
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E6487
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0086EB
BCBS
TX
05
—
109366803
—
TX
01
—
DD7678
RAILROAD MEDICARE
—
Enumeration date
03/18/2009
Last updated
03/18/2009
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