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General NPI Number Information
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NPI Number | 1043480171
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Entity Type | Organization
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Legal Business Name | MARTIN C. MOLINA, MD,PA
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 6618 SITIO DEL RIO BLVD SUITE B-101
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City | AUSTIN
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State | TX
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Zip | 78730-1143
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Country | US
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Telephone | 512-524-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 6618 SITIO DEL RIO BLVD SUITE B-101
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City | AUSTIN
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State | TX
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Zip | 78730-1143
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Country | US
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Telephone | 512-524-2336
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN C MOLINA
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Credential | MD
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Telephone | 512-524-2336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | M0185
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License Number State | TX
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