Individual
GWENDOLYN GIAN MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7901 METROPOLIS DR, AUSTIN, TX 78744-3111
(254) 743-1724
Mailing address
1901 VETERANS MEMORIAL DR, TEMPLE, TX 76504-7451
(254) 743-1724
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP136445
TX
Other
Enumeration date
03/21/2019
Last updated
03/21/2019
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