Provider Demographics
NPI:1851989347
Name:MOLINA, JAVIER (RPH)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:MOLINA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20101 CLOUGHMORE CT
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2688
Mailing Address - Country:US
Mailing Address - Phone:210-385-1083
Mailing Address - Fax:
Practice Address - Street 1:4601 183A TOLL RD
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6310
Practice Address - Country:US
Practice Address - Phone:512-690-9083
Practice Address - Fax:512-690-9084
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38578183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist