MEDICARE: CARMEN ALEJANDRA IBARRA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1417847831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN ALEJANDRA IBARRA

Provider Business Mailing Address
First Line	:	3306 TEAWICK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-1944
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3306 TEAWICK CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-1944
Country	:	US
Telephone Number	:	832-857-8510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/07/2025

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Directions to “ CARMEN ALEJANDRA IBARRA ” Practice Location

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