Individual
MAURO ALBERTO MOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13601 PRESTON RD, DALLAS, TX 75240-4911
(972) 715-5000
(972) 715-5015
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5000
(972) 715-5015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
698320
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192251001
—
TX
05
—
192251002
—
TX
01
—
88716U
BLUE CROSS BLUE SHIELD
TX
01
—
89610U
BCBS
TX
Enumeration date
02/15/2008
Last updated
03/04/2010
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