Provider Demographics
NPI:1447294657
Name:MOLINA, PABLO (MD)
Entity type:Individual
Prefix:DR
First Name:PABLO
Middle Name:
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 CAMERON LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4462
Mailing Address - Country:US
Mailing Address - Phone:972-501-5600
Mailing Address - Fax:
Practice Address - Street 1:1525 W WALNUT HILL LN
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3705
Practice Address - Country:US
Practice Address - Phone:214-596-2421
Practice Address - Fax:877-782-9128
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136713806Medicaid
TXC19460Medicare UPIN
TX136713806Medicaid