| Subodh K Mallik, MD | |
|
387 W Ih 10, Fort Stockton, TX 79735-2700 | |
| (432) 336-0700 | |
| (432) 336-0704 |
| Full Name | Subodh K Mallik |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 34 Years |
| Location | 387 W Ih 10, Fort Stockton, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689628885 | NPI | - | NPPES |
| 111902608 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K4945 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Express Nursing | Odessa, TX | Home health agency |
| St Josephs Home Health Inc | Midland, TX | Home health agency |
| Home Hospice | Odessa, TX | Hospice |
| Ward Memorial Hospital | Monahans, TX | Hospital |
| Pecos County Memorial Hospital | Fort stockton, TX | Hospital |
| Medical Center Hospital | Odessa, TX | Hospital |
| Monahans Managed Care Center | Monahans, TX | Nursing home |
| Fort Stockton Living & Rehabilitation | Fort stockton, TX | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| County Of Ward | 1456261494 | 12 |
| Entity Name | County Of Ward |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881782423 PECOS PAC ID: 1456261494 Enrollment ID: O20040414001322 |
| Entity Name | Seminole Hospital District Of Gaines County Texas |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821025990 PECOS PAC ID: 2668382516 Enrollment ID: O20040428000104 |
| Entity Name | Texas Emergency Staffing Solutions Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811942949 PECOS PAC ID: 0345297610 Enrollment ID: O20050407001290 |
| Entity Name | County Of Ward |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1720096019 PECOS PAC ID: 1456261494 Enrollment ID: O20061104000162 |
| Entity Name | Ess Of South Texas Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295128247 PECOS PAC ID: 9739491176 Enrollment ID: O20150629000248 |
| Mailing Address | Practice Location Address |
|---|---|
| Subodh K Mallik, MD 387 W Ih 10, Fort Stockton, TX 79735-2700 Ph: (432) 336-0700 | Subodh K Mallik, MD 387 W Ih 10, Fort Stockton, TX 79735-2700 Ph: (432) 336-0700 |