Provider Demographics
NPI:1194747253
Name:MALINOWSKI, DOROTA MALGORZATA (MD)
Entity type:Individual
Prefix:
First Name:DOROTA
Middle Name:MALGORZATA
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DOROTA
Other - Middle Name:MALGORZATA
Other - Last Name:MALINOWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4118 POND HILL RD BLDG 3
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1281
Mailing Address - Country:US
Mailing Address - Phone:210-494-3739
Mailing Address - Fax:210-490-2164
Practice Address - Street 1:4118 POND HILL RD BLDG 3
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1281
Practice Address - Country:US
Practice Address - Phone:210-494-3739
Practice Address - Fax:210-490-2164
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3857207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00754980OtherRRMC
TXP00754980OtherRRMC
TXH65606Medicare UPIN
TXH65606Medicare UPIN