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Individual

DR. MALCOLM POL MACCONMARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MB BCH.

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7208
(214) 645-1919
(214) 645-1918
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-1919
(214) 645-1918

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Q0967
TX
208600000X
Surgery Physician
2007010552
MO
208600000X
Surgery Physician
Primary
Q0967
TX

Other

Enumeration date
07/28/2007
Last updated
09/16/2014
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