Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | P7129 | TX |
NPI | 1013115104 |
---|---|
Provider Name | Dr. Rhiana Dawn Ireland |
First Address | Dallas, TX 75284-7176 |
Second Address | Longview, TX 75605-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 04/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
321607901 | (05) | TX |
P7129 | MEDICAL LICENSE (01) | TX |