Healthcare Provider Details

I. General information

NPI: 1194137497
Provider Name (Legal Business Name): ALONZO MOLINAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2014
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10175 GATEWAY BLVD W SUITE 210
EL PASO TX
79925-7618
US

IV. Provider business mailing address

10175 GATEWAY BLVD W SUITE 210
EL PASO TX
79925-7618
US

V. Phone/Fax

Practice location:
  • Phone: 915-590-7900
  • Fax: 915-590-7902
Mailing address:
  • Phone: 915-590-7900
  • Fax: 915-590-7902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: