Provider Demographics
NPI:1417216862
Name:ILIANAI TORRES-ROCA, M.D., P.A.
Entity Type:Organization
Organization Name:ILIANAI TORRES-ROCA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ILIANAI
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-ROCA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-274-0733
Mailing Address - Street 1:300 EVERGREEN OAK CIR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8478
Mailing Address - Country:US
Mailing Address - Phone:210-274-0733
Mailing Address - Fax:
Practice Address - Street 1:1350 W WALNUT HILL LN
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3025
Practice Address - Country:US
Practice Address - Phone:210-274-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9518261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health