Organization Active NPI

Molina Medical Group PLLC

  • Family Medicine Physician
  • Rosenberg, TX
National Provider Identifier
1801583323
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MOLINA MEDICAL GROUP PLLC
Practice address
2201 1St St Ste 6
Rosenberg, TX 77471-5019
Phone
(281) 817-6667
NPI assigned
Apr 24, 2023
Last updated
Apr 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Authorized official

Name
Jerlys Suarez Lopez
Title
FNP
Phone
(832) 996-6911

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Urgent Care Clinic/Center 261QU0200X NU
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

2201 1St St Ste 6
Rosenberg, TX 77471-5019

Mailing address

3026 Coachmaker TRL
Rosenberg, TX 77471-1530
Phone (281) 817-6667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230519002015 TX Part B Supplier - Clinic/Group Practice 7214393057 Receives reassigned benefits from 1 practitioner
Practice locations: Rosenberg, TX; Duncanville, TX

National Provider Directory

National Provider Directory

Locations

408 E Camp Wisdom Rd
#B
Duncanville, TX 75116
Phone (281) 817-6667

2201 1st St
Ste 6
Rosenberg, TX 77471
Phone (281) 817-6667

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682380800000",
    "number": "1801583323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 COACHMAKER TRL",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774711530",
            "telephone_number": "281-817-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 1ST ST STE 6",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774715019",
            "telephone_number": "281-817-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLINA MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "JERLYS",
        "authorized_official_middle_name": "SUAREZ",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "832-996-6911"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosenberg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.