Provider Demographics
NPI:1255609921
Name:IRBY, RATONDA LACRESE
Entity type:Individual
Prefix:
First Name:RATONDA
Middle Name:LACRESE
Last Name:IRBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 MLK BLVD
Mailing Address - Street 2:UNIT 2611
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77048-3732
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11911 MLK BLVD
Practice Address - Street 2:UNIT 2611
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77048-3732
Practice Address - Country:US
Practice Address - Phone:832-746-2572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care