Provider Demographics
NPI:1013125889
Name:MINZE, MOLLY GRAHAM (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:GRAHAM
Last Name:MINZE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:MOLLY
Other - Middle Name:ELLEN
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1718 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3044
Mailing Address - Country:US
Mailing Address - Phone:325-676-7948
Mailing Address - Fax:
Practice Address - Street 1:1718 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3044
Practice Address - Country:US
Practice Address - Phone:325-676-7948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX432251835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX43225OtherSTATE BOARD OF PHARMACY