MEDICARE: PATRICK F MOLLIGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0106X	Orthopaedic Hand Surgery Physician	J3556	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8G8290	OTHER	TX	BCBS
2	119703100	OTHER	TX	FIRSTCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669475372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK F MOLLIGAN M.D.

Provider Business Mailing Address
First Line	:	4642 N LOOP 289
Second Line	:	STE 219
City	:	LUBBOCK
State	:	TX
Zip	:	79416-2425
Country	:	US
Telephone Number	:	806-795-7762
Fax Number	:	806-796-7168

Provider Business Practice Location Address
First Line	:	4642 N LOOP 289
Second Line	:	STE 219
City	:	LUBBOCK
State	:	TX
Zip	:	79416-2425
Country	:	US
Telephone Number	:	806-795-7762
Fax Number	:	806-796-7168

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	09/24/2009

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