Provider Demographics
NPI:1669475372
Name:MOLLIGAN, PATRICK F (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:F
Last Name:MOLLIGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4642 N LOOP 289
Mailing Address - Street 2:STE 219
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-2425
Mailing Address - Country:US
Mailing Address - Phone:806-795-7762
Mailing Address - Fax:806-796-7168
Practice Address - Street 1:4642 N LOOP 289
Practice Address - Street 2:STE 219
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-2425
Practice Address - Country:US
Practice Address - Phone:806-795-7762
Practice Address - Fax:806-796-7168
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3556207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G8290OtherBCBS
TX119703100OtherFIRSTCARE
TX1264939Medicaid
TX119703100OtherFIRSTCARE
TX1264939Medicaid
TX8B2554Medicare PIN