Provider Demographics
NPI:1417401613
Name:IRELAND, DAVID (CNIM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:IRELAND
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7313
Mailing Address - Country:US
Mailing Address - Phone:713-255-5097
Mailing Address - Fax:713-626-2337
Practice Address - Street 1:5222 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3311
Practice Address - Country:US
Practice Address - Phone:713-255-5097
Practice Address - Fax:713-626-2337
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
3504OtherCNIM