Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | H3120 | TX |
NPI | 1538165162 |
---|---|
Provider Name | Dr. Migdalia Molina |
First Address | San Antonio, TX 78205-1116 |
Second Address | San Antonio, TX 78205-1116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 15/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
137925705 | (05) | TX |
C19463 | (02) | TX |