Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | K3911 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | TX-K3911 | TX |
NPI | 1255330064 |
---|---|
Provider Name | Dr. Teresa Lynn Irwin |
First Address | San Marcos, TX 78666-7546 |
Second Address | San Marcos, TX 78666-7546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 04/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0310765-02 | (05) | TX |
H20040 | (02) |