Provider Demographics
NPI:1407255086
Name:BABL, MOLLY RUTH (PA-C)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:RUTH
Last Name:BABL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:RUTH
Other - Last Name:TRAUERNICHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1428 W HEBRON PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6347
Mailing Address - Country:US
Mailing Address - Phone:972-939-4555
Mailing Address - Fax:972-939-7020
Practice Address - Street 1:1428 W HEBRON PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-6347
Practice Address - Country:US
Practice Address - Phone:972-939-4555
Practice Address - Fax:972-939-7020
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA08673363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant