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SUBODH K MALLIK MD PA
NPI 1477847234
Clinic/Center - Rural Health in Fort Stockton, TX

Active since June 08, 2011CLIA 45D2150206 · Waiver
2071 N MAIN ST, FORT STOCKTON, TX 79735(432) 336-0700 Get Directions Write a Review

NPPES record last updated: June 8, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Subodh K Mallik Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUBODH K MALLIK MD PA (NPI 1477847234) is a healthcare organization registered as a rural health in Fort Stockton, Texas and active in the NPI registry since June 2011. The organization holds a CLIA Waiver certificate valid through June 18, 2028 and lists Subodh Mallik, Dr./owner, as its authorized official.

NPPES Registry Identity

NPI1477847234
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameSUBODH K MALLIK MD PA
Location Address2071 N MAIN STFort Stockton, TX 79735-3041
Mailing Address2071 N Main StFort Stockton, TX 79735-3041
Phone(432) 336-0700
Organization SubpartNo
Authorized OfficialSubodh MallikDr./owner · (432) 336-0700
Enumeration DateJune 8, 2011
✔ NPI 1477847234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
2071 N MAIN ST, Fort Stockton, TX 79735
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2150206

Dr Subodh K Mallik MD · Fort Stockton, TX
Active · expires Jun 18, 2028
CLIA Number45D2150206
Laboratory TypePhysician Office
Certificate Effective DateJune 19, 2026
Certificate Expiration DateJune 18, 2028
Laboratory DirectorSubodh K. Mallik
Laboratory Phone(432) 299-7108
Laboratory LocationDr Subodh K Mallik MD237 West 21st, Fort Stockton, TX 79735
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUBODH K MALLIK, MD, PA
Family Medicine
2071 N MAIN ST
FORT STOCKTON, TX 79735
Pecos County (432) 336-0700
MR. KEN THOMAS VONGSAVATH PAC
Family Medicine
2071 N MAIN ST
FT STOCKTON, TX 79735
Pecos County (432) 336-0700
RURAL DENTAL CARE SOLUTIONS, PLLC
Dentist
2071 N MAIN ST
FORT STOCKTON, TX 79735
Pecos County (830) 688-3253

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Subodh K Mallik MD PA's NPI number?

The NPI number for Subodh K Mallik MD PA is 1477847234. It was assigned to this organization in the NPPES registry on June 8, 2011.

Where is Subodh K Mallik MD PA located?

Subodh K Mallik MD PA is located at 2071 N Main St, Fort Stockton, TX 79735. The listed phone number is (432) 336-0700.

What is Subodh K Mallik MD PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Subodh K Mallik MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2150206) is associated with this NPI, valid through June 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Subodh K Mallik MD PA was last updated on June 8, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.