Provider Demographics
NPI:1134649874
Name:IREROA, ANGELA O
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:O
Last Name:IREROA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19221 BEECHNUT ST APT 335
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-5213
Mailing Address - Country:US
Mailing Address - Phone:956-220-5551
Mailing Address - Fax:
Practice Address - Street 1:19221 BEECHNUT ST APT 335
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-5213
Practice Address - Country:US
Practice Address - Phone:956-220-5551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care