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Jonathan Charles Malmrose, MD
Military Health Care Provider in Jbsa Lackland, Texas
NPI 1104528595

Jonathan Charles Malmrose is a Military Health Care Provider based in San Antonio, TX. Jonathan Charles Malmrose practices in Jbsa Lackland, TX and has the professional credentials of MD. The NPI Number for Jonathan Charles Malmrose is 1104528595 and holds a License No. (Texas).

The current practice location address for Jonathan Charles Malmrose is 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX and can be reached out via phone at 818-269-9567.

Location: 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX, 78234-4504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104528595
Provider Name
Jonathan Charles Malmrose
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland, TX, 78234-4504
Phone Number
818-269-9567
Fax Number
Provider Enumeration Date
03/20/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1100 Wilford Hall Loop Bldg 4554
City
Jbsa Lackland
State
Texas
Zip
78236-5638
Phone Number
818-269-9567
Fax Number
person
Provider Business Mailing Address Details
Address
1100 Wilford Hall Loop Bldg 4554
City
Jbsa Lackland
State
Texas
Zip
78236-5638
Phone Number
818-269-9567
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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