Individual provider Active NPI

Rodolfo Molina, M.D.

  • Psychiatry Physician
  • Dallas, TX
National Provider Identifier
1083619605
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J2895 Issued in TX
Practice address
17300 Dallas Pkwy Ste 1005
Dallas, TX 75248-1145
Phone
(817) 873-0595
Fax
(817) 873-0596
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J2895 TX Primary

Addresses

Primary practice location

17300 Dallas Pkwy Ste 1005
Dallas, TX 75248-1145

Mailing address

17300 Dallas Pkwy Ste 1005
Dallas, TX 75248-1145
Phone (817) 873-0595

Other identifiers 1

IdentifierTypeStateIssuer
12190303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000664 TX Practitioner - Psychiatry 6103001375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2485 E Southlake Blvd
Suite 100
Southlake, TX 76092-6687
Phone (817) 873-0595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J2895TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Psychiatric Associates PA Psychiatry CurrentSince May 23, 2019 Accepting new patients

Locations

17300 Dallas Pkwy
Ste 1005
Dallas, TX 75248

17300 Dallas Pkwy
Ste 1006
Dallas, TX 75248
Phone (817) 873-0595

2485 E Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (817) 873-0595

1100 E Southlake Blvd
Ste 300
Southlake, TX 76092
Phone (817) 873-0590

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1083619605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 DALLAS PKWY STE 1005",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481145",
            "telephone_number": "817-873-0595",
            "fax_number": "817-873-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 DALLAS PKWY STE 1005",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481145",
            "telephone_number": "817-873-0595",
            "fax_number": "817-873-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "RODOLFO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J2895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12190303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.