Mark Mallory
Counselor, Professional in Lubbock, TX. Individual provider (NPI-1).
NPI number1144628124
StatusActive
Last updated in NPPESDec 8, 2014
Details
- NPI
- 1144628124
- Entity type
- Individual (NPI-1)
- Name
- Mark Mallory
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 8, 2014
- Last updated
- Dec 8, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
Practice location
1628 19th StLubbock, TX 79401-4832
Phone 806-219-0500 · Fax 806-766-1286
Mailing address
1628 19th StLubbock, TX 79401-4832
Phone 806-219-0500 · Fax 806-766-1286
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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