Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | M6480 | TX |
Y | 111NI0900X | Internist | M6480 | TX |
N | 207RG0300X | Geriatric Medicine | M6480 | TX |
N | 207RH0002X | Hospice and Palliative Medicine | M6480 | TX |
NPI | 1114120631 |
---|---|
Provider Name | Dr. Joanna K Ira |
First Address | Houston, TX 77025-2411 |
Second Address | Houston, TX 77030-4123 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2007 |
Last Update Date | 18/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8M9182 | BLUE CROSS BLU SHIELD (01) | TX |
TXB158820 | MEDICARE GROUP PTAN (01) | TX |
TXB158821 | MEDICARE INDIVIDUAL PTAN (01) | TX |