Healthcare Provider Details
I. General information
NPI: 1033113303
Provider Name (Legal Business Name): MOLLY ANN SALINAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2005
Last Update Date: 03/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
123 STONE OAK LOOP STE 100
SAN ANTONIO TX
78258
US
IV. Provider business mailing address
13750 SAN PEDRO AVE SUITE 560
SAN ANTONIO TX
78232-4375
US
V. Phone/Fax
- Phone: 210-495-7334
- Fax: 210-495-7203
- Phone: 210-561-3100
- Fax: 210-545-3076
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | J9539 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: