Provider Demographics
NPI:1932210846
Name:MOLINA, JAMES THOMAS (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:MOLINA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4660 DUNLEITH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7702
Mailing Address - Country:US
Mailing Address - Phone:409-236-1633
Mailing Address - Fax:409-727-5777
Practice Address - Street 1:2830 CALDER ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1809
Practice Address - Country:US
Practice Address - Phone:409-236-1633
Practice Address - Fax:409-727-5777
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0184207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172554102Medicaid
TX1725544103Medicaid
TX172554101Medicaid
TX8J1215Medicare UPIN
TX8F0848Medicare UPIN
TX1725544103Medicaid