Provider Demographics
NPI:1427545128
Name:MOLINAR, SKIE (PTA)
Entity Type:Individual
Prefix:MS
First Name:SKIE
Middle Name:
Last Name:MOLINAR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12709 TOEPPERWEIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3259
Mailing Address - Country:US
Mailing Address - Phone:210-477-5151
Mailing Address - Fax:
Practice Address - Street 1:12709 TOEPPERWEIN RD STE 101
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3259
Practice Address - Country:US
Practice Address - Phone:210-477-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2011938225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant