Provider Demographics
NPI:1013115104
Name:IRELAND, RHIANA DAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:RHIANA
Middle Name:DAWN
Last Name:IRELAND
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:PO BOX 847176
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7176
Mailing Address - Country:US
Mailing Address - Phone:903-237-1800
Mailing Address - Fax:903-237-1810
Practice Address - Street 1:2901 N 4TH ST
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5128
Practice Address - Country:US
Practice Address - Phone:903-232-3675
Practice Address - Fax:903-232-8542
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7129207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX321607901Medicaid
TXP7129OtherMEDICAL LICENSE
TX269038YKS4Medicare PIN
TX321607901Medicaid