Individual
SCOTT A. IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3800 S W S YOUNG DR STE 201, KILLEEN, TX 76542-3340
(254) 245-9175
(254) 213-7771
Mailing address
PO BOX 11538, KILLEEN, TX 76547-1538
(254) 245-9175
(254) 213-7771
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
L8741
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
L8741
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165738906
—
TX
01
—
P01265608
RR MEDICARE
TX
01
—
TXB165802
MEDICARE PTAN
TX
Enumeration date
09/22/2005
Last updated
08/09/2022
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