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Individual

MS. ELLEN THERESE MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN,NP

Contact information

Practice address
2922 MARTIN LUTHER KING JR BLVD, BUILDING B, DALLAS, TX 75215-2321
(214) 426-3645
(214) 426-2231
Mailing address
3228 DARVANY DR, DALLAS, TX 75220-1614
(214) 351-2356
(214) 426-2231

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
435024
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
435024
RN LICENSE NUMBER
TX
Enumeration date
09/17/2006
Last updated
07/09/2007
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