Active NPI
Molly Kathryn Augustine, M.D.
- Psychiatry Physician
- Southlake, TX
National Provider Identifier
1689710212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- R2809
- Practice address
- 1205 S White Chapel Blvd Ste 285
Southlake, TX 76092-9331 - Phone
- (817) 527-1099
- NPI assigned
- Jan 30, 2007
- Last updated
- Jan 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | R2809 | TX | Primary |
Addresses
Primary practice location
1205 S White Chapel Blvd Ste 285
Southlake, TX 76092-9331
Mailing address
504 Potomac PL
Southlake, TX 76092-9317
Phone (443) 392-5561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R2809 | TX | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1689710212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 POTOMAC PL",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760929317",
"telephone_number": "443-392-5561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 S WHITE CHAPEL BLVD STE 285",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760929331",
"telephone_number": "817-527-1099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTINE",
"first_name": "MOLLY",
"middle_name": "KATHRYN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "R2809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.