Provider Demographics
NPI:1962813626
Name:MOLINAS, VIVIANA (LMT)
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:
Last Name:MOLINAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20501 KATY FWY STE 130
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1940
Mailing Address - Country:US
Mailing Address - Phone:281-578-0606
Mailing Address - Fax:
Practice Address - Street 1:20501 KATY FWY STE 130
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1940
Practice Address - Country:US
Practice Address - Phone:281-578-0606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT119447225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist