DR. MAZYAR MALAKOUTI (NPI# 1962845305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962845305 |
| Entity Type | Individual |
| Full Name | DR. MAZYAR MALAKOUTI |
| Credential | M.D. |
| Practice Address |
505 S Nolen Dr Ste A Southlake TX 76092-9167 |
| Mailing Address |
7703 Floyd Curl Dr San Antonio TX 78229-3901 |
| Practice Telephone | 8174241525 |
| Practice Fax Number | 8174243491 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2019-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | R1079 | TX | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
R1079 | TX | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | R1079 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CSHCN | 371268902 | 01 |
| TX | 371268901 | 05 |
| Street Address |
505 S NOLEN DR STE A |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-9167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821290651 | Kanthi Yalamanchili | Internal Medicine | 505 S Nolen Dr Ste A, Southlake, TX 76092-9167 | 2007-06-04 |
| 1396031977 | Nishita Patel Kara | Internal Medicine | 505 S Nolen Dr Ste A, Southlake, TX 76092-9167 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821290651 | Kanthi Yalamanchili | Internal Medicine | 505 S Nolen Dr Ste A, Southlake, TX 76092-9167 | 2007-06-04 |
| 1740266196 | James J Weber | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-19 |
| 1831395995 | Karen June Steffer | Internal Medicine | 505 S Nolen Dr, Suite A, Southlake, TX 76092-9167 | 2007-06-25 |
| 1891724100 | Jody W. Houston | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2006-06-30 |
| 1649256546 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 505 S Nolen Dr, Ste A, Southlake, TX 76092-9167 | 2005-12-22 |
| 1316923261 | Stephen W Lacey | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-21 |
| 1134105083 | Jeffrey A Smith | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-21 |
| 1235115189 | Timothy E Ritter | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-21 |
| 1639155005 | David K Spady | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-19 |
| 1699751065 | David R Levitan | Internal Medicine | 505 S Nolen Dr, Southlake, TX 76092-9167 | 2005-12-19 |
| Find all providers in SOUTHLAKE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.