Provider Demographics
NPI:1538490396
Name:IRR MEDICAL P.A.
Entity Type:Organization
Organization Name:IRR MEDICAL P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:RAFIQ
Authorized Official - Last Name:RANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-543-9103
Mailing Address - Street 1:621 TUMBLEWEED DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-4755
Mailing Address - Country:US
Mailing Address - Phone:870-543-9103
Mailing Address - Fax:972-552-9949
Practice Address - Street 1:621 TUMBLEWEED DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-4755
Practice Address - Country:US
Practice Address - Phone:870-543-9103
Practice Address - Fax:972-552-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1881815017OtherNPI
TX2021354Medicaid
TX8F23677Medicare PIN