Healthcare Provider Details

I. General information

NPI: 1316967102
Provider Name (Legal Business Name): FRANCIS ROBERTO IBARRA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 11/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15101 EAST FWY
CHANNELVIEW TX
77530-4104
US

IV. Provider business mailing address

PO BOX 203616
HOUSTON TX
77216-3636
US

V. Phone/Fax

Practice location:
  • Phone: 713-626-3379
  • Fax: 713-626-3351
Mailing address:
  • Phone: 281-358-8114
  • Fax: 281-358-0609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberH3896
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH3896
License Number StateTX

VIII. Authorized Official

Name: FRANCIS ROBERTO IBARRA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-348-0426