Provider Demographics
NPI:1780924787
Name:MALACARA, JOSE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:MALACARA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MINA DE ORO ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6764
Mailing Address - Country:US
Mailing Address - Phone:956-458-0655
Mailing Address - Fax:
Practice Address - Street 1:2409 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-1007
Practice Address - Country:US
Practice Address - Phone:956-205-6755
Practice Address - Fax:956-205-6781
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist