Provider Demographics
NPI:1528857810
Name:MALAKOUTI, MARJAN (DPT)
Entity type:Individual
Prefix:
First Name:MARJAN
Middle Name:
Last Name:MALAKOUTI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 MAITLAND LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3028
Mailing Address - Country:US
Mailing Address - Phone:214-803-4905
Mailing Address - Fax:214-803-4905
Practice Address - Street 1:2028 MAITLAND LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3028
Practice Address - Country:US
Practice Address - Phone:214-803-4905
Practice Address - Fax:214-803-4905
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1400386225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist