Individual
DEBRA IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
275 JACKSON ST, BASTROP, TX 78602-4316
(512) 321-7137
Mailing address
275 JACKSON ST, BASTROP, TX 78602-4316
(512) 321-7137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G3490
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080074790
—
TX
05
—
080182504
—
TX
05
—
125459103
—
TX
05
—
125459106
—
TX
01
—
P00601597
RR PTAN
TX
Enumeration date
07/29/2006
Last updated
02/04/2025
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