Provider Demographics
NPI:1508876061
Name:CHIUCCHINI, IRENE (MD)
Entity Type:Individual
Prefix:
First Name:IRENE
Middle Name:
Last Name:CHIUCCHINI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 GATEWAY BLVD W
Mailing Address - Street 2:STE. 120
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-3331
Mailing Address - Country:US
Mailing Address - Phone:915-779-1716
Mailing Address - Fax:915-771-6558
Practice Address - Street 1:7806 GATEWAY BLVD E
Practice Address - Street 2:STE. 102
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1800
Practice Address - Country:US
Practice Address - Phone:915-590-3777
Practice Address - Fax:915-590-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3662207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H95VOtherBCBS
TX00H95VMedicare PIN
TX00H95VOtherBCBS