Provider Demographics
NPI:1417193954
Name:IRINA A. MININA, MD, PLLC
Entity Type:Organization
Organization Name:IRINA A. MININA, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MININA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-542-2188
Mailing Address - Street 1:1201 E. ALTON GLOOR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3937
Mailing Address - Country:US
Mailing Address - Phone:956-542-2188
Mailing Address - Fax:956-542-2190
Practice Address - Street 1:5241 WILDERNESS DRIVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3937
Practice Address - Country:US
Practice Address - Phone:956-542-2188
Practice Address - Fax:956-542-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0982207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty