Provider Demographics
NPI:1255447512
Name:DIGILOVA, IRINA (MD)
Entity type:Individual
Prefix:DR
First Name:IRINA
Middle Name:
Last Name:DIGILOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRINA
Other - Middle Name:
Other - Last Name:DIGILOVA, M.D., P.A.
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6302 WEST BROADWAY STREET
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-7828
Mailing Address - Country:US
Mailing Address - Phone:281-529-6242
Mailing Address - Fax:281-741-4104
Practice Address - Street 1:6302 WEST BROADWAY STREET
Practice Address - Street 2:SUITE 230
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7828
Practice Address - Country:US
Practice Address - Phone:281-529-6242
Practice Address - Fax:281-741-4104
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL32822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148028704Medicaid
TX148028704Medicaid
TXH50578Medicare UPIN