Provider Demographics
NPI:1063651156
Name:MALIK, AMYN (MD)
Entity type:Individual
Prefix:DR
First Name:AMYN
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-0534
Mailing Address - Country:US
Mailing Address - Phone:469-251-0589
Mailing Address - Fax:817-381-3321
Practice Address - Street 1:4100 HERITAGE AVE STE 102
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-5714
Practice Address - Country:US
Practice Address - Phone:469-251-0589
Practice Address - Fax:817-381-3321
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH14085207RC0000X
TNMD44575207RC0000X
TXP7307207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease