Individual
ERNESTO MALAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 CLEAR CREEK RD STE 104, KILLEEN, TX 76549-4985
(254) 432-4028
Mailing address
PO BOX 938, KILLEEN, TX 76540-0938
(254) 634-6999
(254) 200-4099
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J7063
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N96L
BCBS PROVIDER
TX
01
—
J7063
STATE LICENSE
TX
01
—
X0125187
DPS REGISTRATION NUMBER
TX
Enumeration date
08/30/2006
Last updated
08/28/2025
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