MEDICARE: MR. ALFREDO MOLINA PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	616943	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831316124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFREDO MOLINA PMHNP-BC

Provider Business Mailing Address
First Line	:	3800 N MESA
Second Line	:	SUITE A2, #201
City	:	EL PASO
State	:	TX
Zip	:	79902
Country	:	US
Telephone Number	:	915-383-7354
Fax Number	:	915-275-5521

Provider Business Practice Location Address
First Line	:	1900 DENVER AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-3008
Country	:	US
Telephone Number	:	915-544-4000
Fax Number	:	915-532-0733

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

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	05/13/2020

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