Provider Demographics
NPI:1013310333
Name:IRALPH.COM LLC
Entity type:Organization
Organization Name:IRALPH.COM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:RIVERA
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:214-543-9909
Mailing Address - Street 1:9701 LANCASHIRE DR N
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8774
Mailing Address - Country:US
Mailing Address - Phone:214-543-9909
Mailing Address - Fax:214-594-9017
Practice Address - Street 1:9701 LANCASHIRE DR N
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8774
Practice Address - Country:US
Practice Address - Phone:214-543-9909
Practice Address - Fax:214-594-9017
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRALPH.COM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251C00000X, 251E00000X, 251J00000X, 251S00000X, 253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12424532Other12424532
TX9701Other9701
TX10191951Other10191951
TX2145439909Other2145439909
TX75087Other75087