Provider Demographics
NPI:1386147544
Name:PODKORYTOVA, IRINA MIKHAYLOVNA (MD)
Entity type:Individual
Prefix:DR
First Name:IRINA
Middle Name:MIKHAYLOVNA
Last Name:PODKORYTOVA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8508
Mailing Address - Country:US
Mailing Address - Phone:214-648-9197
Mailing Address - Fax:214-648-6320
Practice Address - Street 1:5323 HARRY HINES BLVD # E1.202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7208
Practice Address - Country:US
Practice Address - Phone:214-648-2291
Practice Address - Fax:241-648-6320
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2019-09-23
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Provider Licenses
StateLicense IDTaxonomies
TX468562084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology