Provider Demographics
NPI:1578138418
Name:GILLARD, IRINA V (HEALTH COATCH)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:V
Last Name:GILLARD
Suffix:
Gender:F
Credentials:HEALTH COATCH
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23804 MACEDONIA RD
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-6006
Mailing Address - Country:US
Mailing Address - Phone:713-851-3466
Mailing Address - Fax:
Practice Address - Street 1:23804 MACEDONIA RD
Practice Address - Street 2:
Practice Address - City:HOCKLEY
Practice Address - State:TX
Practice Address - Zip Code:77447-6006
Practice Address - Country:US
Practice Address - Phone:713-851-3466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
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