Provider Demographics
NPI:1265477756
Name:JULIO MOLINA M.D., PA
Entity Type:Organization
Organization Name:JULIO MOLINA M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:C
Authorized Official - Last Name:MOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-342-6595
Mailing Address - Street 1:1601 MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3230
Mailing Address - Country:US
Mailing Address - Phone:281-342-6595
Mailing Address - Fax:281-232-4010
Practice Address - Street 1:1601 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3247
Practice Address - Country:US
Practice Address - Phone:281-342-6595
Practice Address - Fax:281-232-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMD5010207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179581701Medicaid
TXE04516Medicare UPIN
TX179581701Medicaid
TX8F1131Medicare ID - Type Unspecified