Individual
JEREMY CHIP MALOUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 4TH ST DEPT OF, LUBBOCK, TX 79430-4206
(806) 743-1000
Mailing address
3601 4TH ST DEPT OF, LUBBOCK, TX 79430-0002
(806) 743-1000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
549804
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
R3709
TX
208600000X
Surgery Physician
33671
SC
208600000X
Surgery Physician
BP1 0036959
TX
Other
Enumeration date
05/17/2010
Last updated
06/11/2019
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