Provider Demographics
NPI:1184230252
Name:IRIELLE, LOVINA O (PHARMD)
Entity Type:Individual
Prefix:
First Name:LOVINA
Middle Name:O
Last Name:IRIELLE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 BERLIN LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78753-7324
Mailing Address - Country:US
Mailing Address - Phone:281-912-4499
Mailing Address - Fax:
Practice Address - Street 1:3614 BILL PRICE RD BLDG 12DEL
Practice Address - Street 2:
Practice Address - City:DEL VALLE
Practice Address - State:TX
Practice Address - Zip Code:78617-3630
Practice Address - Country:US
Practice Address - Phone:512-854-4197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX52933208U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208U00000XAllopathic & Osteopathic PhysiciansClinical Pharmacology