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NPI 1114120631

NPI 1114120631 : JOANNA K IRA M.D. : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1114120631
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    Entity Type          |    Individual 
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    Provider Name        |    JOANNA K IRA M.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/11/2007
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    Last Update Date     |    07/18/2016
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Provider Practice Location Address
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    Address Line         |    1905 HOLCOMBE BLVD 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77030-4123
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    Country              |    US
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    Telephone            |    713-677-7262
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    Fax                  |    713-677-7184
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Provider Business Mailing Address
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    Address Line         |    3855 TARTAN LN 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77025-2411
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    Country              |    US
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    Telephone            |    281-413-8078
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    M6480
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    207RG0300X
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    Taxonomy Name        |    Geriatric Medicine (Internal Medicine) Physician
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    License Number       |    M6480
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    License Number State |    TX
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Taxonomy #3
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    Taxonomy Code        |    207RH0002X
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    Taxonomy Name        |    Hospice and Palliative Medicine (Internal Medicine) Physician
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    License Number       |    M6480
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    License Number State |    TX
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Taxonomy #4
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    Taxonomy Code        |    208M00000X
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    Taxonomy Name        |    Hospitalist Physician
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    License Number       |    M6480
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    License Number State |    TX
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