Provider Demographics
NPI:1770814170
Name:MIGUEL ANGEL MOLINAS MD PA
Entity Type:Organization
Organization Name:MIGUEL ANGEL MOLINAS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:MOLINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-544-0977
Mailing Address - Street 1:PO BOX 3492
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-3492
Mailing Address - Country:US
Mailing Address - Phone:956-550-9400
Mailing Address - Fax:956-544-0992
Practice Address - Street 1:5235 SOUTHMOST RD STE A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-8056
Practice Address - Country:US
Practice Address - Phone:956-544-0977
Practice Address - Fax:956-544-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121262303Medicaid
TX121262303Medicaid