Individual
HILEEN E MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
828 MYER LN, KERMIT, TX 79745-4634
(432) 586-2040
Mailing address
828 MYER LN, KERMIT, TX 79745-4634
(432) 586-2040
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
MA003289L
PA
363AM0700X
Medical Physician Assistant
Primary
PA09912
TX
Other
Enumeration date
11/23/2005
Last updated
09/08/2015
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