Provider Demographics
NPI:1033177928
Name:MOLOSSI, SILVANA MARIA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SILVANA
Middle Name:MARIA
Last Name:MOLOSSI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:SILVANA
Other - Middle Name:MOLOSSI
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:6621 FANNIN ST # WT19
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2303
Mailing Address - Country:US
Mailing Address - Phone:832-826-5635
Mailing Address - Fax:832-826-5630
Practice Address - Street 1:6621 FANNIN ST # WT19
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2303
Practice Address - Country:US
Practice Address - Phone:832-826-5635
Practice Address - Fax:832-826-5630
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL93102080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167935908Medicaid
TXI18846Medicare UPIN
TX167935908Medicaid
TX8D3192Medicare ID - Type Unspecified