# IRINA V BORISSOVA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1689641649
- **Gender:** F
- **Credential:** MD, PHD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | N1268 | TX | — |
| 207LP3000X | Pediatric Anesthesiology Physician | 21550 | MS | Yes |
| 207LP3000X | Pediatric Anesthesiology Physician | N1268 | TX | — |
| 208000000X | Pediatrics Physician | N1268 | TX | — |

## Other

- **Enumeration date:** 03/08/2006
- **Last updated:** 06/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06276558 | — | MS |
| 05 | — | 197750601 | — | TX |
| 05 | — | 197750605 | — | TX |
| 01 | — | 197750606 | CSHCN | TX |
| 01 | — | 302I050811 | MEDICARE PTAN | MS |
| 01 | — | N1268 | STATE LICENSE | TX |