| Organization Name: | MOLINA MEDICAL MANAGEMENT GROUP LTD |
| NPI Number: | 1417922766 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRANDI MICHELE GIBSON PAHARI (PRACTICE ADMINISTRATOR) |
| Mailing Address: | 1901 W Irving Blvd Irving |
| State: | TX US |
| Postal Code: | 750616826 |
| Phone Number: | 9722596900 |
| Fax Number: | 9722545501 |
| NPI Enumeration Date: | 02/21/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |