Provider Demographics
NPI:1326217944
Name:DUBOW, MOLLY S (PT)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:S
Last Name:DUBOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LOUISIANA AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2856
Mailing Address - Country:US
Mailing Address - Phone:361-853-0488
Mailing Address - Fax:
Practice Address - Street 1:1001 LOUISIANA AVE STE 402
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2856
Practice Address - Country:US
Practice Address - Phone:361-853-0488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145076225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist