Provider Demographics
NPI:1932648128
Name:SPRINGATE, MOLLY
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SPRINGATE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N PRESTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-8876
Mailing Address - Country:US
Mailing Address - Phone:972-347-1320
Mailing Address - Fax:972-347-1322
Practice Address - Street 1:301 N PRESTON RD STE B
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-8876
Practice Address - Country:US
Practice Address - Phone:972-347-1320
Practice Address - Fax:972-347-1322
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133340363L00000X
FLAPRN11014704363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner