Individual
DR. DAMIEN B MALLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 FOREST LN, BLDG. C SUITE 204, DALLAS, TX 75230-2571
(972) 566-5266
(972) 566-5245
Mailing address
7777 FOREST LN, C204, DALLAS, TX 75230-2571
(972) 566-5266
(972) 566-5245
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
L0393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157312301
—
TX
05
—
157312302
—
TX
05
—
157312303
—
TX
05
—
157312304
—
TX
01
—
8A5534
BCBSTX
TX
Enumeration date
03/21/2006
Last updated
11/20/2012
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