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General NPI Number Information
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NPI Number | 1760017065
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Entity Type | Individual
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Provider Name | PAULINE N IREAGBU GEORGE PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/06/2020
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 117 MELBOURNE RD
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City | HURST
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State | TX
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Zip | 76053-6318
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Country | US
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Telephone | 682-202-0591
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Fax | 682-334-7615
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Provider Business Mailing Address
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Address Line | 117 MELBOURNE RD
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City | HURST
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State | TX
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Zip | 76053-6318
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Country | US
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Telephone | 682-202-0591
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Fax | 682-334-7615
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1086536
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 909820
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License Number State | TX
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