Provider Demographics
NPI:1083769665
Name:IRINA DIGILOVA, M.D., P.A.
Entity Type:Organization
Organization Name:IRINA DIGILOVA, M.D., P.A.
Other - Org Name:IRINA DIGILOVA, M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLIOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-529-6242
Mailing Address - Street 1:6302 WEST BROADWAY STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7828
Mailing Address - Country:US
Mailing Address - Phone:281-529-6242
Mailing Address - Fax:281-741-4104
Practice Address - Street 1:6302 WEST BROADWAY STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7828
Practice Address - Country:US
Practice Address - Phone:281-529-6242
Practice Address - Fax:281-741-4104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL32822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH50578Medicare UPIN