Basic Information
| Provider Information | |||||||||
| NPI: | 1831596642 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | IRONS | ||||||||
| FirstName: | KERRY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 W LOOP 340 | ||||||||
| Address2: | SUITE A | ||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767126841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547760418 | ||||||||
| FaxNumber: | 2547419638 | ||||||||
| Practice Location | |||||||||
| Address1: | 2712 CRESTHILL CIR | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767101016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547765042 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2014 | ||||||||
| LastUpdateDate: | 11/21/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | E3712 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.