Provider Demographics
NPI:1033272745
Name:CAWI, IRENE C (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:C
Last Name:CAWI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:KERMIT
Mailing Address - State:TX
Mailing Address - Zip Code:79745-0093
Mailing Address - Country:US
Mailing Address - Phone:432-940-2600
Mailing Address - Fax:
Practice Address - Street 1:910 B SOUTH GRANT
Practice Address - Street 2:
Practice Address - City:ODESSA,
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-580-7404
Practice Address - Fax:432-580-7570
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX576611363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily