Provider Demographics
NPI:1538165162
Name:MOLINA, MIGDALIA (MD)
Entity type:Individual
Prefix:DR
First Name:MIGDALIA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N MAIN
Mailing Address - Street 2:STE 515
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1116
Mailing Address - Country:US
Mailing Address - Phone:210-224-7601
Mailing Address - Fax:210-224-1763
Practice Address - Street 1:730 N MAIN
Practice Address - Street 2:STE 515
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1116
Practice Address - Country:US
Practice Address - Phone:210-224-2024
Practice Address - Fax:210-224-1763
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3120207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137925705Medicaid
TX137925705Medicaid
TX00H07PMedicare PIN