Healthcare Provider Details

I. General information

NPI: 1710737234
Provider Name (Legal Business Name): PATRICK AXEL MOLINA MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1161
COPPELL TX
75019-1104
US

IV. Provider business mailing address

PO BOX 1161
DALLAS TX
75219-8161
US

V. Phone/Fax

Practice location:
  • Phone: 770-366-5009
  • Fax:
Mailing address:
  • Phone: 770-366-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberW8596
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberW8596
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: