{
"Npi": {
"NPI": "1609118017",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "CORNELL-ADE",
"FirstName": "IRENE",
"MiddleName": "EKENE",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "M.D",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "IGWEBIKE",
"OtherFirstName": "IRENE",
"OtherMiddleName": "EKENE",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "M.D",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 301173",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75303-1173",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2610 ORLEANS WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MISSOURI CITY",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77459-7316",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-546-4498",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/23/2013",
"LastUpdateDate": "04/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "01076900A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "207Q00000X",
"TaxonomyName": "Family Medicine Physician",
"LicenseNumber": "4548I",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}