Provider Demographics
NPI:1790785988
Name:ORPILLA, IMELDA M (WHCNP)
Entity Type:Individual
Prefix:
First Name:IMELDA
Middle Name:M
Last Name:ORPILLA
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5201 HARRY HINES BLVD
Practice Address - Street 2:WISH TUBAL CLINIC
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7708
Practice Address - Country:US
Practice Address - Phone:214-590-5306
Practice Address - Fax:214-590-2798
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX603626363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163699506Medicaid
TX163699507Medicaid
TX163699510Medicaid
TX8N4810OtherBLUE CROSS BLUE SHIELD
TX163699502Medicaid
TX163699505Medicaid
TX163699509Medicaid
TX163699503Medicaid
TX163699504Medicaid
TX163699508Medicaid
TX163699501Medicaid
TX163699511Medicaid