Individual
ASIA MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8317 YAUPON HOLLY TRL, FORT WORTH, TX 76123-1696
(317) 500-2475
Mailing address
8317 YAUPON HOLLY TRL, FORT WORTH, TX 76123-1696
(469) 783-1999
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
48333024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92-2574972
—
TX
Enumeration date
02/27/2023
Last updated
01/08/2024
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