Provider Demographics
NPI:1194155457
Name:IKIRU, PLLC
Entity type:Organization
Organization Name:IKIRU, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:GUERRA GAROFALO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-587-7965
Mailing Address - Street 1:5460 BABCOCK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3905
Mailing Address - Country:US
Mailing Address - Phone:210-587-7965
Mailing Address - Fax:210-587-7968
Practice Address - Street 1:5460 BABCOCK RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3905
Practice Address - Country:US
Practice Address - Phone:210-587-7965
Practice Address - Fax:210-587-7968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty