# MOLINA MEDICAL MANAGEMENT GROUP LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Molina Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417922766
- **Authorized official:** MRS. BRANDI MICHELE GIBSON PAHARI (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (972) 259-6900

## Contact information

- **Practice address:** 1901 W IRVING BLVD, IRVING, TX 75061-6826
- **Practice address phone:** (972) 259-6900
- **Practice address fax:** (972) 254-5501
- **Mailing address:** 1901 WEST IRVING BLVD, IRVING, TX 75061-6026
- **Mailing address phone:** (972) 259-6900
- **Mailing address fax:** (972) 254-5501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2006
- **Last updated:** 08/22/2020