Dr. Irene Rae Willingham
Sports Medicine Doctor
4809 Cole Ave Suite 110
Dallas
, Texas 75205-3578
Dr. Irene Rae Willingham
Sports Medicine Doctor
4809 Cole Ave Suite 110
Dallas
, Texas 75205-3578
(214) 443-3897
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About
Features
Specialties
- Sports Medicine Doctor
Languages spoken
- English
Location
First Address
- Dr. Irene Rae Willingham
- 4809 Cole Ave Suite 110
- Dallas, TX
- Zip : 75205-3578
- Fax : (214) 443-3897
- Phone : (214) 526-8600
Second Address
- Dr. Irene Rae Willingham
- 4809 Cole Ave Suite 110
- Dallas, TX
- Zip : 75205-3578
- Fax : (214) 443-3897
- Phone : (214) 526-8600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | H0463 | TX |
National Provider Identifier
| NPI | 1376570101 |
|---|---|
| Provider Name | Dr. Irene Rae Willingham |
| First Address | Dallas, TX 75205-3578 |
| Second Address | Dallas, TX 75205-3578 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/06/2006 |
| Last Update Date | 11/04/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.