DR. CAROL ELIZABETH MALLETTE (NPI# 1558300756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558300756 |
| Entity Type | Individual |
| Full Name | DR. CAROL ELIZABETH MALLETTE |
| Credential | M.D. |
| Practice Address |
1201 Summit Ave Fort Worth TX 76102-4427 |
| Mailing Address |
6445 Harris Pkwy Ste. 100 Fort Worth TX 76132-4138 |
| Practice Telephone | 8173360379 |
| Practice Fax Number | 8173325117 |
| Mailing Telephone | 8173616900 |
| Mailing Fax Number | 8172632918 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
M3308 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
1201 SUMMIT AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76102-4427 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881690279 | Aziz Samir Abdul-rahim | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4427 | 2005-06-22 |
| 1891313037 | Jordan L Haney | Nurse Practitioner | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2020-07-13 |
| 1487073953 | Derek Yang Han | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2014-04-14 |
| 1679991053 | Tina Chen | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2014-04-02 |
| 1942634662 | Harper Interventional Pain Center LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2013-08-29 |
| 1356685861 | Marsh Interventional Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2012-11-21 |
| 1265701767 | Judy Marie Myers | Optometrist | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2011-12-29 |
| 1124310073 | Penn Interventional Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2011-05-11 |
| 1790089720 | Presidio Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2011-01-05 |
| 1295045854 | Summit Avenue Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2010-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113746 | Deirdre P Browne | Counselor | 1500 E El Paso, Fort Worth, TX 76102 | 2018-08-07 |
| 1740784206 | Cvs Pharmacy Inc | Pharmacy | 515 Houston St, Fort Worth, TX 76102 | 2018-03-20 |
| 1316448061 | Diondra Deshawn Narcisse | Licensed Vocational Nurse | 1314 Lake Street, Fort Worth, TX 76102 | 2018-02-27 |
| 1649779943 | Carmela A Solis | Specialist/Technologist, Other | 500 Throckmorton Street Unit 3309, Fort Worth, TX 76102 | 2018-02-02 |
| 1104324516 | Vicki Webb-baker | Health Educator | 512 Lamar Street, Suite 400, Fort Worth, TX 76102 | 2018-01-31 |
| 1235647678 | Brianna Marie Keister | Occupational Therapist | 201 W. Lancaster Ave, 417, Fort Worth, TX 76102 | 2018-01-19 |
| 1437507910 | Medical Hearing Services, LLC | Hearing Aid Equipment | 1201 Summit Avenue, Fort Worth, TX 76102 | 2016-05-25 |
| 1891171476 | Karis Starke | Physical Therapy Assistant | 2500 West Freeway (i-30), 100, Fort Worth, TX 76102 | 2015-08-05 |
| 1265839344 | Fm Katy Dental and Orthodontics, Pllc | Dentist | 100 E 15th Ste 520, Fort Worth, TX 76102 | 2014-12-04 |
| 1093134512 | Superior Evaluation Services | General Practice | 420 Throckmorton Suite 200, Ft. Worth, TX 76102 | 2014-04-11 |
| Find all providers in zip 76102 | ||||
| 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 |
|---|---|---|---|---|
| 1770929614 | Vikram Anand | Internal Medicine | 1350 S Main St Ste 3200, Fort Worth, TX 76104-7669 | 2013-05-20 |
| 1750655221 | Texas Health Care, Pllc | Internal Medicine | 800 8th Ave Ste 632, Fort Worth, TX 76104-2617 | 2012-03-01 |
| 1598963746 | Priya Rangasamy | Internal Medicine | 909 9th Ave Ste 205, Fort Worth, TX 76104-3916 | 2007-07-10 |
| 1306946934 | Jay Beckwith | Internal Medicine | 1051 Haskell St, 208, Fort Worth, TX 76107-2649 | 2006-09-24 |
| 1912915034 | Nataraj Kasal | Internal Medicine | 6300 Ridglea Pl Ste 1103, Fort Worth, TX 76116-5737 | 2006-08-04 |
| 1720005523 | Gastroenterology Associates of North Texas, LLP | Internal Medicine | 900 W Magnolia Ave Ste 100, Fort Worth, TX 76104-8518 | 2006-07-16 |
| 1588616205 | Shahid Aziz | Internal Medicine | 1650 W Rosedale St Ste 302, Fort Worth, TX 76104-7400 | 2006-05-17 |
| 1790745990 | Donald R Johnson | Internal Medicine | 1111 5th Ave, Fort Worth, TX 76104-4302 | 2006-03-23 |
| 1265411920 | Jeffrey L.. Krieger | Internal Medicine | 9509 N Beach St, Ste 101, Fort Worth, TX 76244-6399 | 2006-01-11 |
| 1992781330 | Pavani Muddasani | Internal Medicine | 508 S Adams St Ste 202, Fort Worth, TX 76104-2151 | 2005-12-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76102 |
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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.